Bipolar electrosurgical hand shears

ABSTRACT

An apparatus comprises a first jaw, a second jaw, a first handle, and a second handle. The second jaw is pivotally coupled with the first jaw. The first jaw and the second jaw are configured to grasp tissue. The jaws provide offset electrode surfaces that are operable to deliver bipolar RF energy to tissue grasped between the jaws. The apparatus is further operable to sever tissue. A lockout feature selectively prevents tissue severing, based on an energization state of the jaws.

This application is a continuation of U.S. application Ser. No.13/752,588, filed Jan. 29, 2013, entitled “Bipolar Electrosurgical HandShears,” issued as U.S. Pat. No. 9,610,114 on Apr. 4, 2017.

BACKGROUND

A variety of surgical instruments include one or more elements thattransmit RF energy to tissue (e.g., to coagulate or seal the tissue).Some such instruments comprise a pair of jaws that open and close ontissue, with conductive tissue contact surfaces that are operable toweld tissue clamped between the jaws. In open surgical settings, somesuch instruments may be in the form of forceps having a scissor grip.

In addition to having RF energy transmission elements, some surgicalinstruments also include a translating tissue cutting element. Anexample of such a device is the ENSEAL® Tissue Sealing Device by EthiconEndo-Surgery, Inc., of Cincinnati, Ohio. Further examples of suchdevices and related concepts are disclosed in U.S. Pat. No. 6,500,176entitled “Electrosurgical Systems and Techniques for Sealing Tissue,”issued Dec. 31, 2002, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,112,201 entitled “ElectrosurgicalInstrument and Method of Use,” issued Sep. 26, 2006, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,125,409,entitled “Electrosurgical Working End for Controlled Energy Delivery,”issued Oct. 24, 2006, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,169,146 entitled “ElectrosurgicalProbe and Method of Use,” issued Jan. 30, 2007, the disclosure of whichis incorporated by reference herein; U.S. Pat. No. 7,186,253, entitled“Electrosurgical Jaw Structure for Controlled Energy Delivery,” issuedMar. 6, 2007, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 7,189,233, entitled “Electrosurgical Instrument,”issued Mar. 13, 2007, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,220,951, entitled “Surgical SealingSurfaces and Methods of Use,” issued May 22, 2007, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,309,849,entitled “Polymer Compositions Exhibiting a PTC Property and Methods ofFabrication,” issued Dec. 18, 2007, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,311,709, entitled“Electrosurgical Instrument and Method of Use,” issued Dec. 25, 2007,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 7,354,440, entitled “Electrosurgical Instrument and Method of Use,”issued Apr. 8, 2008, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,381,209, entitled “ElectrosurgicalInstrument,” issued Jun. 3, 2008, the disclosure of which isincorporated by reference herein.

Additional examples of electrosurgical cutting instruments and relatedconcepts are disclosed in U.S. Pub. No. 2011/0087218, entitled “SurgicalInstrument Comprising First and Second Drive Systems Actuatable by aCommon Trigger Mechanism,” published Apr. 14, 2011, now U.S. Pat. No.8,939,974, issued on Jan. 27, 2015, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0116379, entitled“Motor Driven Electrosurgical Device with Mechanical and ElectricalFeedback,” published May 10, 2012, now U.S. Pat. No. 9,161,803, issuedon Oct. 20, 2015, the disclosure of which is incorporated by referenceherein; U.S. Pub. No. 2012/0078243, entitled “Control Features forArticulating Surgical Device,” published Mar. 29, 2012, issued as U.S.Pat. No. 9,877,720, on Jan. 30, 2018, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0078247, entitled“Articulation Joint Features for Articulating Surgical Device,”published Mar. 29, 2012, now U.S. Pat. No. 9,402,682, issued on Aug. 2,2016, the disclosure of which is incorporated by reference herein; U.S.patent application Ser. No. 13/622,729, entitled “Surgical Instrumentwith Multi-Phase Trigger Bias,” filed Sep. 19, 2012, now U.S. Pat. No.9,089,327, issued on Jul. 28, 2015, the disclosure of which isincorporated by reference herein; and U.S. patent application Ser. No.13/622,735, entitled “Surgical Instrument with Contained Dual HelixActuator Assembly,” filed Sep. 19, 2012, now U.S. Pat. No. 9,545,253,issued on Jan. 17, 2017, the disclosure of which is incorporated byreference herein.

While several medical devices have been made and used, it is believedthat no one prior to the inventors has made or used the inventiondescribed in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a perspective view of an exemplary forceps instrument;

FIG. 2 depicts a side view of the instrument of FIG. 1 in a closedposition;

FIG. 3 depicts a side exploded view of the instrument of FIG. 1;

FIG. 4 depicts an enlarged perspective view of the jaws of theinstrument of FIG. 1;

FIG. 5 depicts a front, cross sectional view of the jaws of FIG. 4, withthe cross section taken along line 5-5 of FIG. 2;

FIG. 6 depicts a perspective view of an exemplary alternative jaw withan insert;

FIG. 7 depicts a front, cross sectional view of the jaw of FIG. 6;

FIG. 8 depicts a perspective view of exemplary alternative jaws withinserts;

FIG. 9 depicts a front, cross sectional view of the jaw of FIG. 8;

FIG. 10A depicts a front, cross sectional view of an exemplaryalternative version of an insert for jaws of a forceps instrument, withthe jaws clamping tissue;

FIG. 10B depicts a front, cross sectional view of the insert of FIG. 10Awith the jaws welding tissue;

FIG. 10C depicts a front, cross sectional view of the insert of FIG. 10Awith the jaws cutting tissue;

FIG. 11A depicts a front, cross sectional view of an exemplaryalternative insert for jaws of a forceps instrument, with the jawsclamping tissue;

FIG. 11B depicts a front, cross sectional view of the insert of FIG.11A, with the jaws welding tissue;

FIG. 11C depicts a front, cross sectional view of the insert of FIG.11A, with the jaws cutting tissue;

FIG. 12 depicts a perspective view of an exemplary alternative insertfor a jaw of a forceps instrument with a pressure edge;

FIG. 13 depicts a front, cross sectional view of the insert of FIG. 12inserted into jaws;

FIG. 14 depicts a perspective view of an exemplary alternative insertfor a jaw of a forceps instrument being inserted into a jaw;

FIG. 15 depicts a front, cross sectional view of the insert of FIG. 14inserted into jaws;

FIG. 16 depicts a front, cross sectional view of an exemplaryalternative insert in jaws of a forceps instrument shaped to fit aknife;

FIG. 17 depicts a front, cross sectional view of the insert of FIG. 16clamping tissue with the knife advanced;

FIG. 18 depicts a perspective view of an exemplary alternative versionof jaws of a forceps instrument with diagonally positioned electrodes;

FIG. 19 depicts a front, perspective view of the jaws of FIG. 18;

FIG. 20 depicts a perspective cross sectional view of an exemplaryalternative version of jaws with externally facing electrodes;

FIG. 21 depicts a perspective cross sectional view of an exemplaryalternative version of jaws for a forceps instrument with externalelectrodes and a vertically oriented I-beam;

FIG. 22 depicts a perspective cross sectional view of the jaws of FIG.21 rotated ninety degrees counterclockwise and pressed against tissue;

FIG. 23 depicts a perspective view of exemplary alternative jaws for aforceps instrument having checkerboard style contours;

FIG. 24 depicts a cross sectional view of the jaws of FIG. 23 takenalong line 24-24 in FIG. 23;

FIG. 25 depicts a cross sectional view of the jaws of FIG. 23 takenalong line 25-25 in FIG. 23;

FIG. 26 depicts a cross sectional view of the jaws of FIG. 23 takenalong line 26-26 in FIG. 23;

FIG. 27 depicts a cross sectional perspective view of exemplaryalternative jaws for a forceps instrument;

FIG. 28 depicts a perspective view of exemplary alternative jaws for aforceps instrument;

FIG. 29 depicts a perspective view of exemplary alternative jaws for aforceps instrument;

FIG. 30 depicts a side view of an exemplary alternative forcepsinstrument with a two button actuation system for energizing andcutting;

FIG. 31 depicts a side view of an exemplary alternative forcepsinstrument with a two stage actuation trigger;

FIG. 32 depicts a side view of an exemplary alternative forcepsinstrument with an energizing button and a cutting trigger;

FIG. 33A depicts a side view of an exemplary alternative forcepsinstrument with a knife lock out trigger integrated with an energizingbutton;

FIG. 33B depicts a side view of the forceps instrument of FIG. 33A withthe energizing button pressed;

FIG. 33C depicts a side view of the forceps instrument of FIG. 33A withthe energizing button pressed and the lockout trigger pulled;

FIG. 34A depicts a side view of an exemplary alternative forcepsinstrument with a knife lock out trigger integrated with an energizingbutton;

FIG. 34B depicts a side view of the forceps instrument of FIG. 34A withthe energizing button pressed;

FIG. 34C depicts a side view of the forceps instrument of FIG. 34A withthe energizing button pressed and the lockout trigger pulled;

FIG. 35 depicts a side view of an exemplary alternative forcepsinstrument with a cam slot operated knife lock;

FIG. 36A depicts a side view of a knife and jaw of the instrument ofFIG. 35 with the knife engaging the cam features;

FIG. 36B depicts a side view of the knife and jaw of FIG. 36A with theknife disengaging the cam features;

FIG. 37 depicts a perspective view of a coupler of an exemplaryalternative forceps instrument;

FIG. 38A depicts a side view of an exemplary forceps instrumentincorporating the coupler of FIG. 37 with jaws open;

FIG. 38B depicts a side view of the forceps instrument of FIG. 38A withthe jaws clamped;

FIG. 38C depicts a side view of the forceps instrument of FIG. 38A withthe jaws energized;

FIG. 38D depicts a side view of the forceps instrument of FIG. 38A witha knife advancing;

FIG. 38E depicts a side view of the forceps instrument of FIG. 38A withthe jaws released;

FIG. 39 depicts a side view of an exemplary alternative forcepsinstrument with a knife lock out trigger;

FIG. 40A depicts a partial side view of the forceps instrument of FIG.39 with jaws closed;

FIG. 40B depicts a partial side view of the forceps instrument of FIG.39 with the lockout trigger actuated;

FIG. 41 depicts a side view of an exemplary alternative forcepsinstrument with a knife lockout feature;

FIG. 42A depicts a partial side view of the forceps instrument of FIG.41 with jaws closed;

FIG. 42B depicts a partial side view of the forceps instrument of FIG.41 with a trigger disengaging the handle and the knife advancing;

FIG. 42C depicts a partial side view of the forceps instrument of FIG.41 with the jaws released;

FIG. 43A depicts a side view of an exemplary alternative forcepsinstrument with a knife lockout trigger;

FIG. 43B depicts a side view of the forceps instrument of FIG. 43A withthe jaws closed and the knife lockout trigger engaged;

FIG. 43C depicts a side view of the forceps instrument of FIG. 43A withthe knife lockout trigger pressed and disengaging the knife;

FIG. 43D depicts a side view of the forceps instrument of FIG. 43A withthe knife advanced;

FIG. 44A depicts a side partial view of an exemplary alternative knifewith an energy sensitive beam;

FIG. 44B depicts a side partial view of the knife shown in FIG. 44A withthe lockout energized;

FIG. 45 depicts a side view of another exemplary alternative forcepsinstrument with a knife lockout feature;

FIG. 46 depicts a side partial view of the knife lockout feature of FIG.45 with the knife lockout trigger disengaged;

FIG. 47A depicts a side view of an exemplary alternative forcepsinstrument with a curved knife advancement rod;

FIG. 47B depicts a side view of the forceps instrument of FIG. 47A withthe curved knife advancement rod advanced;

FIG. 48 depicts a side view of an exemplary alternative forcepsinstrument with a spring loaded knife lockout feature;

FIG. 49A depicts a perspective view of the spring loaded knife lockoutfeature of FIG. 48 engaging the knife;

FIG. 49B depicts a perspective view of the spring loaded knife lockoutfeature of FIG. 48 disengaged and with the knife advanced;

FIG. 50 depicts side cross sectional view of an exemplary alternativeforceps instrument with a motor driven knife;

FIG. 51A depicts a side view of an exemplary alternative forcepsinstrument with ratcheting pads;

FIG. 51B depicts a side view of the forceps instrument of FIG. 51A withthe ratcheting pads closed;

FIG. 52 depicts an enlarged side cross sectional view of the closuretriggered energizing feature using a slip ring;

FIG. 53A depicts a side view of an exemplary alternative forcepsinstrument with a closure triggered energizing feature located near thejaws of the forceps instrument; and

FIG. 53B depicts a side view of the forceps instrument of FIG. 53A withthe jaws closed and the closure triggered energizing feature engaged.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

I. Exemplary Forceps Instrument

FIG. 1 shows an exemplary forceps instrument (10) operable to manipulatetissue. Instrument (10) comprises a first handle (12), a second handle(14), and a pivoting joint (22) that couples handles (12, 14) together.Handles (12, 14) may comprise glass filled nylon and/or any othersuitable material(s). Handles (12, 14) are electrically isolated fromeach other in the present example, as will be described in greaterdetail below. A resilient strip (18) is positioned proximal to pivotingjoint (22) and resiliently biases handles (12, 14) to an openconfiguration as shown in FIG. 1. By way of example only, resilientstrip (18) may comprise a leaf spring. Of course, any other suitablecomponent may be used to resiliently bias handles (12, 14).Alternatively, handles (12, 14) may simply lack a resilient bias.Instrument (10) further comprises a first jaw (42) in communication withfirst handle (12) and a second jaw (44) in communication with secondhandle (14). A cable (20) is also in communication with second handle(14), with a controller (30), and with a power source (32). Instrument(10) also comprises a trigger button (16) mounted on second handle (14).

Generally, instrument (10) is operable to grasp tissue. It will beunderstood that grasping tissue may include grasping the tissue withrelatively little compressive force as well as grasping tissue withmoderate to heavy compressive force. Furthermore, in some instances, itwill be appreciated that a mix of compressive forces may be used. Forinstance, the user may wish to apply light compressive forces to someportions of tissue and heavier forces to other portions of tissue. Insome cases, the user may wish to manipulate (pull, push aside, etc.) thetissue. Manipulation of tissue may include pulling or pushing graspedtissue. Furthermore, the user may even wish to use outer facing portionsof the distal end of instrument (10) to bluntly move tissue in thesurgical area as the user desires. Instrument (10) is further operableto energize the tissue by communicating bipolar RF energy to the tissue,which causes the tissue to weld or seal together. While bipolar RFenergy is delivered by instrument (10) in the present example, it shouldbe understood that other suitable forms of energizing the tissue may beused as would be apparent to one of ordinary skill in the art in view ofthe teachings herein. It should also be understood that before, after,or concurrently with sealing tissue, instrument (10) may be used to cuttissue. In particular, tissue clamped and sealed with instrument (10)may be cut using cutting edges within instrument (10). In addition or inthe alternative, instrument (10) may use an actuating knife or otherblade that moves relative to instrument (10) to cut grasped tissue. Insome versions, other portions of instrument (10) may be moved againsttissue in order to cut or pull apart tissue. By way of example only,jaws (42, 44) may themselves be operable to cut tissue simply bysqueezing handles (12, 14) toward each other with enough force.

Handles (12, 14) are operable to be grasped by a user and squeezedtogether in a scissor grip fashion. While the exemplary version showshandles (12, 14) having a scissor grip configuration, it will beunderstood that other types of grips may be used for handles (12, 14).For instance, handles (12, 14) may have a pistol grip or any othersuitable configuration operable to allow a user to close jaws (42, 44)through manual actuation of handles (12, 14); and to allow a user tomanipulate instrument (10) once tissue is grasped between jaws (42, 44).Jaws (42, 44) have a curved configuration in the present example, but itwill be understood that jaws (42, 44) may have any suitableconfiguration operable to grasp and manipulate tissue as would beapparent to one of ordinary skill in the art in view of the teachingsherein. For instance, in some versions, jaws (42, 44) may have astraight configuration.

Pivoting joint (22) is operable to allow jaws (42, 44) to open and closein response to a user actuating handles (12, 14). It will be understoodthat pivoting joint (22) may comprise any suitable joint or mechanismoperable to allow the closure of jaws (42, 44) in response to useractuation of handles (12, 14) as would be apparent to one of ordinaryskill in the art in view of the teachings herein. Resilient strip (18)is positioned near pivoting joint (22) and engages handles (12, 14) suchthat handles (12, 14) are biased to remain in the open position as seenin FIG. 1. When instrument (10) is in the closed position shown in FIG.2, resilient strip (18) bends as seen in FIG. 2. When the user releaseshandles (12, 14) or simply loosens his or her grip on handles (12, 14),resilient strip (18) pushes apart handles (12, 14) to return instrument(10) to the state shown in FIG. 1.

Trigger button (16) is positioned on second handle (14) and is furtherpositioned close enough to where a user might grip second handle (14)such that a user can grab handles (12, 14) and actuate trigger button(16) with the same hand that grasps handles (12, 14), thereby allowingsingle handed operation of instrument (10). Trigger button (16) maycomprise a single push button as shown in the exemplary version but itwill be understood that trigger button (16) may comprise multiplebuttons or one or more buttons having multiple actuation stages.

Cable (20) comprises an electrically insulated cable in communicationwith controller (30). Cable (20) is further in communication with powersource (32). Cable (20) comprises any suitable structure operable todeliver energy to jaws (42, 44) of instrument (10). In particular, cable(20) comprises at least two wires within cable (20) such that the wiresare operable to deliver bipolar energy to jaws (42, 44). One or morewires may be in communication with first jaw (42) such that first jaw(42) acts as a positive lead whereas another set of one or more wiresextending through cable (20) are in communication with second jaw (44)to act as a negative lead. As such, when jaws (42, 44) clamp tissue anddeliver energy, bipolar energy is delivered to the tissue by passingfrom one jaw (42) through the tissue to the other jaw (44). While cable(20) connects to handle (14), it will be understood that cable (20) maybe in communication with instrument (10) at any suitable portion ofinstrument (10).

Controller (30) and power source (32) are operable to deliver energy toinstrument (10) through cable (20). In particular, controller (30) maycomprise a circuit, processor, memory, and/or any other suitablecomponents operable to start, stop, or otherwise control power source(32). Power source (32) is operable to deliver bipolar energy to jaws(42, 44) through cable (20).

FIG. 3 shows an exploded view of instrument (10) to show generally howenergy is transmitted from power source (32) and controller (30) tocable (20) and then to jaws (42, 44). In particular, cable (20) splitsinto a first wire (46) and a second wire (48). First wire (46) iscoupled with a trigger switch (17), which is selectively opened andclosed by actuation of trigger button (16). Of course, trigger button(16) is just one merely illustrative example of how the circuit may beselectively opened and closed. Any other suitable feature may be used.Trigger switch (17) is resiliently biased to the open position, suchthat a user must push trigger button (16) to close trigger switch (17);and such that trigger switch (17) will again open when the userthereafter releases trigger button (16). Trigger switch (17) is alsocoupled with a third wire (47), which is directly coupled with jaw (44).In some versions, trigger switch (17) is moved to the proximal region ofhandles (12, 14) and trigger button (16) is omitted. Such a proximaltrigger switch (17) may be positioned between surfaces of handles (12,14) that face each other and are moved toward each other when handles(12, 14) are squeezed together. By way of example only, trigger switch(17) may comprise a dome switch that is closed only when handles (12,14) are squeezed together fully, indicating sufficient clamping oftissue between jaws (42, 44) before RF energy may be applied to thetissue. Other suitable positions and variations for trigger switch (17)will be apparent to those of ordinary skill in the art in view of theteachings herein.

Second wire (48) is directly coupled with resilient strip (18), which iselectrically conductive and is further coupled with jaw (42) to providean electrical path to jaw. It should be understood that resilient strip(18) does not contact any conductive regions of handle (14) or jaw (44).While resilient strip (18) itself provides an electrical path in thisexample, it should be understood that resilient strip (18) mayalternatively just provide mechanical support to some other electricalconduit. For instance, a wire may be affixed to the proximal face ofresilient strip (18).

Instrument (10) further comprises insulating pads (50) and insulatingwasher (52). Insulating pads (50) and insulating washer (52) areoperable to electrically insulate first wire (46) and associatedcomponents from second wire (48) and associated components in parts ofinstrument (10) where such positive and negative components are inparticularly close proximity, thereby preventing positive and negativecomponents from short circuiting. Furthermore, as seen in FIG. 4, itwill be understood that portions of handle (12, 14) are constructed ofan insulating exterior (54) such that as wires (46, 48) run throughinstrument (10), wires (46, 48) do not in create short circuits.Insulating exterior (54), insulating washer (52), and/or any otherinsulating features may be used to insulate handles (12, 14) from eachother. It will be understood that jaws (42, 44) must be clamped againsttissue and trigger button (16) must be actuated in order to close acircuit. Upon closing the circuit, bipolar RF energy is provided to thetissue.

Jaws (42, 44) can be seen in cross section in FIG. 5. Jaws (42, 44)define a clamping region therebetween having an asymmetric, stretchedout stair step shape profile such that jaw (42) complements jaw (44). Inparticular, jaw (42) includes a first generally flat region (60), asloped transition region (62), and a second generally flat region (64).Jaw (44) includes a first generally flat region (70), a slopedtransition region (72), and a second generally flat region (74).Transition regions (62, 72) each have the same width (w₁) and a height(h₁). Regions (60, 70) are configured to complement each other, regions(62, 72) are configured to complement each other, and regions (64, 74)are configured to complement each other. Regions (60, 62, 64) thus nestwith corresponding regions (70, 72, 74) when jaws (42, 44) are closedtogether. It should be understood that jaws (42, 44) may contact tissueacross all regions (60, 62, 64, 70, 72, 74). Depending on how much forcethe user applies to handles (12, 14), this contact may simply clamp thetissue or cut the tissue.

In the present example, regions (64, 70) are conductive and apply RFenergy to tissue while regions (60, 62, 72, 74) provide non-conductivetissue contact surfaces. For instance, regions (60, 62, 72, 74) may becoated with electrically insulative material while regions (64, 70)present exposed electrically conductive material (e.g., exposed metal).Regions (64, 70) may thus act as discrete, bipolar electrode surfaces.While jaws (42, 44) are generally formed of electrically conductivematerial in this example, regions (60, 62, 72, 74) include anelectrically insulative coating. It should be understood that thisconfiguration may provide electrode surfaces that are both verticallyoffset from each other and laterally offset from each other when jaws(42, 44) are closed. It should also be understood that thisconfiguration may provide transmission of RF energy along a path that isoblique relative to the longitudinal axis of jaws (42, 44) in thevertical and lateral dimensions, with the path being generally parallelto regions (62, 72). In other words, the region of tissue that actuallyreceives bipolar RF energy will only be the tissue that is contactingand between regions (62, 72). Thus, the tissue will not receive RFenergy across the entire lateral width of jaws (42, 44). Thisconfiguration may thus minimize the thermal spread of heat caused by theapplication of bipolar RF energy to the tissue. Such minimization ofthermal spread may in turn minimize potential collateral damage totissue that is adjacent to the particular tissue region that the surgeonwishes to weld/seal/coagulate and/or cut.

In some other versions, regions (60, 62, 72, 74) are conductive andapply RF energy to tissue while regions (64, 70) provide non-conductivetissue contact surfaces. In still other versions, regions (62, 64, 70,72) are conductive and apply RF energy to tissue while regions (60, 74)provide non-conductive tissue contact surfaces. In yet other versions,regions (60, 74) are conductive and apply RF energy to tissue whileregions (62, 64, 70, 72) provide non-conductive tissue contact surfaces.Alternatively, all regions (60, 62, 64, 70, 72, 74) may be conductiveand apply RF energy to tissue. In any of the foregoing examples, one jaw(42) may be associated with a first polarity while the other jaw (44)may be associated with a second polarity in order to apply bipolar RFenergy to tissue.

As can be seen in FIG. 4, jaws (42, 44) of the present example alsoinclude sets of laterally oriented notches (80) in regions (60, 62, 64,70, 72, 74). It should be understood that notches (80) are merelyoptional. It should also be understood that jaws (42, 44) may have avariety of alternative features and configurations. Several merelyillustrative examples of such alternative features and configurationswill be described in greater detail below, while additional exampleswill be apparent to those of ordinary skill in the art in view of theteachings herein.

II. Exemplary Alternative Jaw Features

FIGS. 6-29 show various examples of alternative forms that jaws (42, 44)may take. It should be understood that the various examples describedbelow may be readily incorporated into instrument (10) and may applybipolar RF energy to tissue. FIG. 6 in particular shows an exemplary jaw(142) having a longitudinally extending slot (150). Slot (150) extendslongitudinally through the center of jaw (142) in this example. Aninsert (152) is slidably received in jaw (142) by sliding insert (152)into slot (150). FIG. 7 shows jaw (142) with insert (152) positionedwithin slot (150). Upper jaw (144) also comprises slot (151) similar toslot of lower jaw (142). A second insert (154) is configured to fit inslot (151). Inserts (152, 154) placed in slots (150, 151) are shaped andoriented such that tissue (160) clamped between inserts (152, 154) isobliquely compressed as shown in FIG. 7. Inserts (152, 154) form adovetail fitting with jaws (142, 144) and are slidable into jaws (142,144) from the rear of jaws (142, 144) in the present example. Of course,any other suitable alternative to a dovetail configuration may be used;and/or inserts (152, 154) may slide in from the distal end of jaws (142,144) if desired.

Inserts (152, 154) of the present example are formed of an electricallyinsulative material, while jaws (142, 144) are formed of an electricallyconductive material. By way of example only, inserts (152, 154) may beformed of a surgical grade plastic and/or a positive temperaturecoefficient (PTC) thermistor polymer, etc. In versions where inserts(152, 154) comprise a PTC thermistor polymer, it should be understoodthat inserts (152, 154) may be electrically conductive when thetemperature of inserts (152, 154) is below a certain threshold; whileinserts (152, 154) may be electrically insulative when the temperatureof inserts (152, 154) is above a certain threshold. Other materials thatmay be used to form inserts (152, 154) will be apparent to those ofordinary skill in the art in view of the teachings herein. By way ofexample only, jaws (142, 144) may be formed of titanium or aluminum thatis anodized or coated with a conductive material such as diamond-likecarbon (DLC), grade 5 titanium, and/or some other material. Othermaterials that may be used to form jaws (142, 144) will be apparent tothose of ordinary skill in the art in view of the teachings herein.

In the present example, inserts (152, 154) fit within jaws (142, 144)such that only a portion of each jaw (142, 144) is covered by therespective insert (152, 154). The tissue contacting regions of jaws(142, 144) that are left exposed by inserts (152, 154) will act aselectrode surfaces, such that the exposed surfaces of jaws (142, 144)are operable to deliver bipolar RF energy to tissue (160). Such deliveryof RF energy may effectively weld/seal/coagulate the tissue (160) asdescribed above, and may further assist with the severing of tissue(160) depending on how much force the user applies to jaws (142, 144) bysqueezing handles (12, 14) toward each other.

In an exemplary use, a user first places inserts (152, 154) into slots(150, 151). In some instances, jaws (142, 144) must be completelyseparated from each other (e.g., completely decoupled at pivoting joint(22), etc.) in order for inserts (152, 154) to slide into slots (150,151). In such versions, jaws (142, 144) are coupled together (e.g., atpivoting joint (22)) after inserts (152, 154) are inserted into slots(150, 151); and the coupling of jaws (142, 144) prevents inserts (152,154) from thereafter sliding out of jaws (142, 144) during use. Inaddition or in the alternative, a snapping feature, interference fit,clip, and/or other feature/technique may be used to secure inserts (152,154) relative to their respective jaws (142, 144). Once jaws (142, 144)are assembled with inserts (152, 154), the user may squeeze handles (12,14) to clamp jaws (142, 144) with inserts (152, 154) against the tissue(160). RF energy is then delivered to the tissue (160) through thetissue contacting surfaces of jaws (142, 144) that are left exposed byinserts (152, 154), thereby welding/sealing/coagulating the tissue(160). The user may then squeeze handles (12, 14) further, eventuallypinching the tissue (160) to the point of cutting the tissue (160) alongwhere inserts (152, 154) meet.

FIGS. 8-9 show exemplary alternative inserts (252, 254) that areconfigured to fit in slots (250, 251) of jaws (242, 244). In thisexample, inserts (252, 254) are insertable into jaws (242, 244) throughthe front of jaws (242, 244), though it should be understood that jaws(242, 244) may alternatively receive inserts (252, 254) from theproximal ends of jaws (242, 244). FIG. 9 shows inserts (252, 254)positioned within jaws (242, 244). Inserts (252, 254) and jaws (242,244) are substantially identical to inserts (152, 154) and jaws (142,144) described above, except that slots (251) and the complementaryfeatures of inserts (152, 154) have a bulb-shaped profile in thisexample instead of having a dovetail-shaped profile. Of course, anyother suitable interface configuration may be used.

FIGS. 10A-10C show yet other set of exemplary alternative inserts (352,354) and jaws (342, 344) that are operable to clamp,weld/seal/coagulate, and cut tissue (360). Inserts (352, 354) of thisexample are welded to jaws (342, 344), though it should be understoodthat inserts (352, 354) may alternatively be secured to jaws (342, 344)using any suitable features and/or techniques. Again, inserts (352, 354)of this example are formed of an electrically insulative material; whilejaws (342, 344) are formed of an electrically conductive material.Inserts (352, 354) comprise ridges (356, 358) that extend along thelongitudinal length of inserts (352, 354). FIG. 10A shows jaws (342,344) urged toward each other to a point where jaws (342, 344) are merelyclamping on tissue (360). FIG. 10B shows jaws (342, 344) urged furthertoward each other, with jaws (342, 344) being energized with RF energy,to a point where jaws (342, 344) are welding/sealing/coagulating tissue(360). FIG. 10C shows jaws (342, 344) urged further toward each other toa point where ridges (356, 358) are severing tissue (360).

It should be understood that the configuration of ridges (356, 358)assist in concentrating the pressure applied through jaws (342, 344) andinserts (352, 354) along the lines of tissue contact established byridges (356, 358). This concentration of pressure may facilitate thesevering of tissue (360) without requiring the user to apply significantforces at handles (12, 14). In the present example, ridges (356, 358)have a generally rounded profile, though it should be understood thatridges (356, 358) may alternatively have a profile that is square,triangular, sharp, or of any other suitable configuration.

FIGS. 11A-11C show yet another set of exemplary alternative inserts(452, 454) and jaws (442, 444) that are operable to clamp,weld/seal/coagulate, and cut tissue (460). Inserts (452, 454) of thisexample fit in shallow slots (450, 451) of jaws (442, 444), though itshould be understood that inserts (452, 454) may alternatively besecured to jaws (442, 444) using any suitable features and/ortechniques. Inserts (452, 454) comprise humps (456, 458) that extendalong the longitudinal length of inserts (452, 454). FIG. 11A shows jaws(442, 444) urged toward each other to a point where jaws (442, 444) aremerely clamping on tissue (460). FIG. 11B shows jaws (442, 444) urgedfurther toward each other, with jaws (442, 444) being energized with RFenergy, to a point where jaws (442, 444) are welding/sealing/coagulatingtissue (460). FIG. 11C shows jaws (442, 444) urged further toward eachother to a point where ridges (456, 458) are severing tissue (460).Humps (456, 458) are configured to generally concentrate pressure beingapplied to tissue (460), such that humps (456, 458) may be viewed as asubstitute for ridges (356, 358) described above.

FIGS. 12-13 show yet another set of exemplary alternative inserts (552,554) and jaws (542, 544) that are operable to clamp,weld/seal/coagulate, and cut tissue (560). Inserts (552, 554) of thisexample slidably fit in respective “T”-shaped slots (550, 551) of jaws(542, 544). Insert (552) comprises a plastic, electrically insulativeportion (553) and a positive temperature coefficient (PTC) thermistorpolymer portion (556). PTC thermistor polymer portion (556) defines araised edge (557). Insert (554) comprises a plastic, electricallyinsulative portion (555) and a PTC thermistor polymer portion (558). PTCthermistor polymer portion (558) defines a raised edge (559). As can beseen in FIG. 13, PTC thermistor polymer portions (556, 558) extendpartially into respective “T”-shaped slots (550, 551), adjacent toplastic, electrically insulative portions (553, 555).

It should be understood that PTC thermistor polymer portions (556, 558)may be electrically conductive when the temperature of PTC thermistorpolymer portions (556, 558) is below a certain threshold; while PTCthermistor polymer portions (556, 558) may be electrically insulativewhen the temperature of PTC thermistor polymer portions (556, 558) isabove a certain threshold. Thus, when the temperature of PTC thermistorpolymer portions (556, 558) is below a certain threshold and RF energyis applied to jaws, RF energy may flow through tissue (560) from PTCthermistor polymer portion (556) to PTC thermistor polymer portion(558). It should be understood that this RF energy flow path throughtissue (560) is oblique, similar to the oblique RF energy path describedabove with respect to jaws (42, 44). RF energy may also flow throughtissue (560) from the tissue contacting surface of jaw (542) to thetissue contacting surface of jaw (544) when the temperature of PTCthermistor polymer portions (556, 558) is below the threshold, stillbeing along an oblique path. Once the temperature of PTC thermistorpolymer portions (556, 558) exceeds the threshold, PTC thermistorpolymer portions (556, 558) become electrically insulative. At thatstage, to the extent that RF energy continues to flow through tissue(560) at all, the RF energy only flows through tissue (560) from thetissue contacting surface of jaw (542) to the tissue contacting surfaceof jaw (544). In some other versions, the entirety of each insert (552,554) consists of insulative plastic, such that a PTC thermistor polymeris not used. In such versions, RF energy may simply flow through tissue(560) from the tissue contacting surface of jaw (542) to the tissuecontacting surface of jaw (544), again along an oblique path.

It should also be understood that raised edges (557, 559) may act aspressure concentration features, concentrating the pressure appliedthrough jaws (542, 544) and inserts (552, 554) along the lines of tissuecontact established by raised edges (557, 559). This concentration ofpressure may facilitate the severing of tissue (560) without requiringthe user to apply significant forces at handles (12, 14). Raised edges(557, 559) are thus similar to ridges (356, 358) and humps (456, 458)described above, though raised edges (557, 559) of this example presenta generally sharper edge than ridges (356, 358) and humps (456, 458).Raised edges (557, 559) are nevertheless not sharp enough to cut tissue(560) in the absence of significant pressure being applied to the tissue(560) in the present example.

Of course, raised edges (557, 559) are merely optional. For instance,FIGS. 14-15 show a set of exemplary alternative inserts (652, 654) andjaws (642, 644) that are similar to inserts (552, 554) and jaws (542,544); and that are operable to clamp, weld/seal/coagulate, and cuttissue. Inserts (652, 654) of this example sidably fit in respective“T”-shaped slots (650, 651) of jaws (642, 644). Insert (652) comprises aplastic, electrically insulative portion (653) and a positivetemperature coefficient (PTC) thermistor polymer portion (656). PTCthermistor polymer portion (656) of this example does not define araised edge or other type of pressure concentration feature. Insert(654) comprises a plastic, electrically insulative portion (655) and aPTC thermistor polymer portion (658). PTC thermistor polymer portion(658) also does not define a raised edge or other type of pressureconcentration feature. As can be seen in FIG. 15, PTC thermistor polymerportions (656, 658) extend partially into respective “T”-shaped slots(650, 651), adjacent to plastic, electrically insulative portions (653,655).

It should be understood that PTC thermistor polymer portions (656, 658)may be electrically conductive when the temperature of PTC thermistorpolymer portions (656, 658) is below a certain threshold; while PTCthermistor polymer portions (656, 658) may be electrically insulativewhen the temperature of PTC thermistor polymer portions (656, 658) isabove a certain threshold. Thus, when the temperature of PTC thermistorpolymer portions (656, 658) is below a certain threshold and RF energyis applied to jaws, RF energy may flow through tissue from PTCthermistor polymer portion (656) to PTC thermistor polymer portion(658). It should be understood that this RF energy flow path throughtissue is oblique, similar to the oblique RF energy path described abovewith respect to jaws (42, 44). RF energy may also flow through tissuefrom the tissue contacting surface of jaw (642) to the tissue contactingsurface of jaw (644) when the temperature of PTC thermistor polymerportions (656, 658) is below the threshold, still being along an obliquepath. Once the temperature of PTC thermistor polymer portions (656, 658)exceeds the threshold, PTC thermistor polymer portions (656, 658) becomeelectrically insulative. At that stage, to the extent that RF energycontinues to flow through tissue at all, the RF energy only flowsthrough tissue from the tissue contacting surface of jaw (642) to thetissue contacting surface of jaw (644). In some other versions, theentirety of each insert (652, 654) consists of insulative plastic, suchthat a PTC thermistor polymer is not used. In such versions, RF energymay simply flow through tissue from the tissue contacting surface of jaw(642) to the tissue contacting surface of jaw (644), again along anoblique path.

It should also be understood that jaws (642, 644) and inserts (652, 654)may still be operable to cut tissue in the absence of raised edges orother tissue concentration features. For instance, jaws (642, 644) andinserts (652, 654) may sever tissue captured between jaws (642, 644) andinserts (652, 654) when handles (12, 14) are squeezed together withsufficient force. In some instances, such tissue may be more easilysevered after RF energy has been applied to the tissue. By way ofexample only, the user may first partially clamp down on the tissue withjaws (642, 644) and inserts (652, 654), apply RF energy to the tissuefor a certain period of time, then clamp down further on the tissue withjaws (642, 644) and inserts (652, 654) to sever the tissue. Othersuitable features and methods of use will be apparent to those ofordinary skill in the art in view of the teachings herein.

III. Exemplary Jaws with Movable Tissue Cutting Feature

In some instances, an alternative cutting feature such as a movableknife may be used to sever tissue, instead of using clamping pressurethrough a variation of jaws (42, 44) to sever tissue. FIGS. 16-17 showan exemplary version of jaws (742, 744) having inserts (752, 754) and anI-beam knife (770). Inserts (752, 754) of this example are substantiallysimilar to inserts (652, 654) described above, except that inserts (752,754) of this example each define “T”-shaped slots (757, 759). Insert(752) comprises a plastic, electrically insulative portion (753) and apositive temperature coefficient (PTC) thermistor polymer portion (756).Insert (754) comprises a plastic, electrically insulative portion (755)and a PTC thermistor polymer portion (758). PTC thermistor polymerportions (756, 758) extend partially into respective “T”-shaped slots(750, 751) of jaws (742, 744), adjacent to plastic, electricallyinsulative portions (753, 755).

It should be understood that PTC thermistor polymer portions (756, 758)may be electrically conductive when the temperature of PTC thermistorpolymer portions (756, 758) is below a certain threshold; while PTCthermistor polymer portions (756, 758) may be electrically insulativewhen the temperature of PTC thermistor polymer portions (756, 758) isabove a certain threshold. Thus, when the temperature of PTC thermistorpolymer portions (756, 758) is below a certain threshold and RF energyis applied to jaws, RF energy may flow through tissue (760) from PTCthermistor polymer portion (756) to PTC thermistor polymer portion(758). It should be understood that this RF energy flow path throughtissue (760) is oblique, similar to the oblique RF energy path describedabove with respect to jaws (42, 44). RF energy may also flow throughtissue (760) from the tissue contacting surface of jaw (742) to thetissue contacting surface of jaw (744) when the temperature of PTCthermistor polymer portions (756, 758) is below the threshold, stillbeing along an oblique path. Once the temperature of PTC thermistorpolymer portions (756, 758) exceeds the threshold, PTC thermistorpolymer portions (756, 758) become electrically insulative. At thatstage, to the extent that RF energy continues to flow through tissue(760) at all, the RF energy only flows through tissue (760) from thetissue contacting surface of jaw (742) to the tissue contacting surfaceof jaw (744). In some other versions, the entirety of each insert (752,754) consists of insulative plastic, such that a PTC thermistor polymeris not used. In such versions, RF energy may simply flow through tissuefrom the tissue contacting surface of jaw (742) to the tissue contactingsurface of jaw (744), again along an oblique path.

I-beam knife (770) of the present example includes a pair of outwardlydirected upper transverse pins (772) and a pair of outwardly directedlower transverse pins (774). In some other versions, pins (772, 774) aresubstituted with transverse flanges and/or some other structure(s). Thevertical distance between pins (772, 774) is fixed in the presentexample. I-beam knife (770) further includes a vertically extendingsharp cutting edge (776). I-beam knife (770) is operable to translatelongitudinally through jaws (742, 744), which would be into and out ofthe page in the views depicted in FIGS. 16-17. Pins (772) are disposedin the upper portion of “T”-shaped slot (759) of insert (754); whilepins (774) are disposed in the lower portion of “T”-shaped slot (757) ofinsert (752).

In use, jaws (742, 744) may be closed on tissue (760) to compress tissue(760) and then weld/seal/coagulate tissue (760) as described above.Then, I-beam knife (770) may be driven distally to cut tissue (760) asshown in FIG. 17. Several merely illustrative examples of how I-beamknife (770) may be driven distally will be described in greater detailbelow; while further examples will be apparent to those of ordinaryskill in the art in view of the teachings herein. In the event that jaws(742, 744) are not fully compressing tissue (760) when I-beam knife(770) is driven distally, pins (772, 774) may act as cams againstinserts (752, 754) to thereby drive jaws (742, 744) to fully compressedpositions.

In some versions, I-beam knife (770) is conductive and provides a returnpath for RF current from one or both of jaws (742, 744). Thus, if RFenergy is applied when I-beam knife (770) is adjacent to tissue (e.g.,during and/or after distal advancement of I-beam knife (770)), RF energymay flow through tissue (760) from the tissue contacting surface of jaw(742) to I-beam knife (770); and/or from the tissue contacting surfaceof jaw (744) to I-beam knife (770). At such a stage of operation, PTCthermistor polymer portions (756, 758) may have been heated to anelectrically insulative state, such that PTC thermistor polymer portions(756, 758) would not serve as a short circuit path between I-beam knife(770) and jaws (742, 744). Alternatively, I-beam knife (770) may beinsulative or may otherwise play no role in RF energy transmission. Forinstance, in some instances no RF energy is applied through jaws (742,744) or I-beam knife (770) at the stage where I-beam knife (770) isdriven through tissue (760).

FIGS. 18-19 show I-beam knife (770) combined with an exemplaryalternative pair of jaws (842, 844). Jaws (842, 844) of this examplehave respective plastic, electrically insulative portions (852, 854),respective positive temperature coefficient (PTC) thermistor polymerportions (856, 858), and respective electrode strips (862, 864).Insulative portions (852, 854) are arranged on opposite sides of avertical plane passing through the center of jaws (842, 844). PTCthermistor portions (856, 858) are also arranged on opposite sides of avertical plane passing through the center of jaws (842, 844). Electrodestrip (862) is secured to the top of insulative portion (852); whileelectrode strip (864) is secured to the top of insulative portion (854).By way of example only, electrode strips (862, 864) may be heat-staked,pinned, glued, overmolded, or otherwise secured to respective insulativeportions (852, 854). Insulative portions (852, 854) may also beheat-staked, pinned, glued, overmolded, or otherwise secured torespective jaws (842, 844). Likewise, PTC thermistor portions (856, 858)may be heat-staked, pinned, glued, overmolded, or otherwise secured torespective jaws (842, 844). Other suitable ways in which theabove-described components may be secured together will be apparent tothose of ordinary skill in the art in view of the teachings herein.

While FIG. 18 only shows a flexible conduit (863) for providing power toelectrode strip (862), it should be understood that a similar conduitmay be coupled with electrode strip (864). It should also be understoodthat such conduits (863) may be coupled with wires (46, 48) describedabove, for activation in response to actuation of trigger button (16),etc.

It should be understood that PTC thermistor polymer portions (856, 858)may be electrically conductive when the temperature of PTC thermistorpolymer portions (856, 858) is below a certain threshold; while PTCthermistor polymer portions (856, 858) may be electrically insulativewhen the temperature of PTC thermistor polymer portions (856, 858) isabove a certain threshold. Thus, when the temperature of PTC thermistorpolymer portions (856, 858) is below a certain threshold and RF energyis applied to jaws, RF energy may flow through tissue (not shown) fromPTC thermistor polymer portion (856) to PTC thermistor polymer portion(858). It should be understood that this RF energy flow path throughtissue is oblique, similar to the oblique RF energy path described abovewith respect to jaws (42, 44). RF energy may also flow through thetissue from electrode strip (862) to electrode strip (864), which isanother oblique path. Furthermore, RF energy may also flow through thetissue from electrode strip (862) to PTC thermistor polymer portion(858); and from electrode strip (864) to PTC thermistor polymer portion(856). It should therefore be understood that RF energy may flow throughtissue along four different paths when PTC thermistor polymer portions(856, 858) are in electrically conductive states.

Once the temperature of PTC thermistor polymer portions (856, 858)exceeds the threshold. PTC thermistor polymer portions (856, 858) becomeelectrically insulative. At that stage, to the extent that RF energycontinues to flow through the tissue at all, the RF energy only flowsthrough the tissue from electrode strip (862) to electrode strip (864).In some other versions, PTC thermistor polymer portions (856, 858) aresubstituted with insulative plastic. In such versions, RF energy maysimply flow through the tissue from electrode strip (862) to electrodestrip (864), again along an oblique path. As another merely illustrativeexample, electrode strips (862, 864) may be omitted and RF energy mayflow through tissue from PTC thermistor polymer portion (856) to PTCthermistor polymer portion (858) until the temperature exceeds athreshold, at which point RF energy stops flowing through the tissue.

As noted above, I-beam knife (770) of the present example includes apair of outwardly directed upper transverse pins (772) and a pair ofoutwardly directed lower transverse pins (774). Pins (772) are disposedin a recess (871) defined in jaw (844); while pins (774) are disposed ina recess (870) defined in jaw (842). I-beam knife (770) is operable totranslate longitudinally through jaws (842, 844), which would be intoand out of the page in the view depicted in FIG. 19. In use, jaws (842,844) may be closed on tissue to compress the tissue and thenweld/seal/coagulate the tissue as described above. Then, I-beam knife(770) may be driven distally to cut the tissue. Again, several merelyillustrative examples of how I-beam knife (770) may be driven distallywill be described in greater detail below; while further examples willbe apparent to those of ordinary skill in the art in view of theteachings herein. In the event that jaws (842, 844) are not fullycompressing the tissue when I-beam knife (770) is driven distally, pins(772, 774) may act as cams against jaws (842, 844) to thereby drive jaws(842, 844) to fully compressed positions.

IV. Exemplary Jaws with External Tissue Sealing Features

The exemplary variations of jaws (42, 44) described above are operableto weld/seal/coagulate tissue that is captured between jaws (42, 44). Insome instances, it may be desirable to weld/seal/coagulate tissue thatis not captured between jaws (42, 44). For instance, after some versionof jaws (42, 44) has been used to sever tissue, after an I-beam knife(770) has been used to sever tissue, and/or after some other feature hasbeen used to sever or otherwise manipulate tissue, there may be aportion of tissue that continues to bleed. It may therefore be desirableto press an exterior portion of one or both of jaws (42, 44) againstsuch a bleeding portion of tissue, to apply bipolar RF energy toseal/coagulate the tissue, without having to grasp the bleeding portionof tissue between jaws (42, 44). FIGS. 20-22 show merely illustrativevariations of jaws (42, 44) that have exterior portions that areoperable to apply bipolar RF energy to tissue. These examples will bedescribed in greater detail below, while other examples will be apparentto those of ordinary skill in the art in view of the teachings herein.

FIG. 20 shows a pair of jaws (942, 944) that are each formed of anelectrically conductive material (e.g., metal) and that each include aselectively applied electrically insulative coating (943). Varioussuitable materials that may be used to form insulative coating (943)will be apparent to those of ordinary skill in the art in view of theteachings herein. Upper jaw (944) comprises a negative polarity portion(950) and a positive polarity portion (960). Similarly, lower jaw (942)comprises a negative polarity portion (970) and a positive polarityportion (980).

Insulative coating (943) covers part of negative polarity portion (950),but leaves an internal tissue contact surface (952) exposed and anexternal tissue contact surface (954) exposed. Insulative coating (943)also covers part of positive polarity portion (960), leaving an internaltissue contact surface (962) exposed and an external tissue contactsurface (964) exposed. Similarly, insulative coating (943) covers partof negative polarity portion (970), leaving an internal tissue contactsurface (972) exposed and an external tissue contact surface (974)exposed. And likewise, insulative coating (943) covers part of positivepolarity portion (980), leaving an internal tissue contact surface (982)exposed and an external tissue contact surface (984) exposed. It shouldbe understood from the foregoing that surfaces (962, 964, 982, 984) areoperable to provide a positive pole for RF energy communication throughtissue; while surfaces (952, 954, 972, 974) are operable to provide anegative pole for RF energy communication through tissue. In some otherversions, one or more of surfaces (952, 954, 962, 964, 972, 974, 982,984) are covered by insulative coating (943). By way of example only,surfaces (962, 972) may be covered by insulative coating (943).

In the present example, surfaces (952, 962, 972, 982) are operable tocommunicate RF energy through tissue that is clamped between jaws (942,944), to thereby weld/seal/coagulate the tissue. In particular, RFenergy may be communicated through tissue from surface (962) to surface(972); and/or from surface (982) to surface (952). As shown in FIG. 20,surfaces (962, 972) are laterally and vertically offset from each otherin this example, such that the RF energy will travel along an obliquepath through tissue from surface (962) to surface (972), similar to theoblique path described above with respect to jaws (42, 44). Similarly,surfaces (952, 982) are also laterally and vertically offset from eachother in this example, such that the RF energy will travel along anoblique path through tissue from surface (982) to surface (952).

Jaws (942, 944) of the present example also together define a slot (990)that is configured to receive I-beam knife (770). Thus, I-beam knife(770) may be used to sever tissue between jaws (942, 944) before,during, or after surfaces (952, 962, 972, 982) are activated toweld/seal/coagulate the tissue. It should be understood that inclusionof I-beam knife (770) is merely optional. By way of example only, jaws(942, 944) may instead include ridges, humps, sharp edges, and/or anyother suitable features that are configured to concentrate pressure ontissue when jaws (942, 944) are sufficiently clamped on the tissue tosever the tissue.

Before or after jaws (942, 944) are used to weld/seal/coagulate tissuecaptured between jaws (942, 944), and perhaps before or after tissue issevered by an I-beam knife (770) that is driven distally through slot(990), the user may rotate jaws (942, 944) approximately ninety degreesabout their longitudinal axis and press the exterior of one of jaws(942, 944) against tissue to seal/coagulate the tissue. For instance,the user may press the exterior of jaw (942) against tissue to placesurfaces (974, 984) in contact with the tissue. Positive and negativepolarity portions (970, 980) may then be energized to apply bipolar RFenergy to the tissue through surfaces (974, 984), therebywelding/sealing the tissue along a region between the tissue contactpoints of surfaces (974, 984). Similarly, the user may press theexterior of jaw (944) against tissue to place surfaces (954, 964) incontact with the tissue. Positive and negative polarity portions (950,960) may then be energized to apply bipolar RF energy to the tissuethrough surfaces (954, 964), thereby sealing/coagulating the tissuealong a region between the tissue contact points of surfaces (954, 964).As with the other variations described herein, it will be appreciatedthat energy may be supplied via control (30) and power source (32) asshown in FIG. 1. However other suitable power sources may be used aswould be apparent to one of ordinary skill in the art in view of theteachings herein. It should also be understood that surfaces (954, 964,974, 984) may be used to seal/coagulate tissue in instances whereneither surfaces (952, 962, 972, 982) are used to weld/seal/coagulatetissue nor an I-beam knife (770) (or other feature) is used to severtissue.

FIGS. 21-22 depict another exemplary set of jaws (1042, 1044) that areoperable to selectively either weld/seal/coagulate tissue between jaws(1042, 1044) or seal/coagulate tissue that is external to jaws (1042,1044). Jaws (1042, 1044) of this example are substantially similar tojaws (842, 844) described above, except that jaws (1042, 1044) of thisexample include exterior electrode strips (1066, 1068). Jaws (1042,1044) of this example have respective plastic, electrically insulativeportions (1052, 1054), respective positive temperature coefficient (PTC)thermistor polymer portions (1056, 1058), and respective interiorelectrode strips (1062, 1064). Insulative portions (1052, 1054) arearranged on opposite sides of a vertical plane passing through thecenter of jaws (1042, 1044). PTC thermistor portions (1056, 1058) arealso arranged on opposite sides of a vertical plane passing through thecenter of jaws (1042, 1044). Interior electrode strip (1062) is securedto the top of insulative portion (1052); while interior electrode strip(1064) is secured to the top of insulative portion (1054). Varioussuitable ways in which the above-described components may be securedtogether will be apparent to those of ordinary skill in the art in viewof the teachings herein.

It should be understood that PTC thermistor polymer portions (1056,1058) may be electrically conductive when the temperature of PTCthermistor polymer portions (1056, 1058) is below a certain threshold;while PTC thermistor polymer portions (1056, 1058) may be electricallyinsulative when the temperature of PTC thermistor polymer portions(1056, 1058) is above a certain threshold. Thus, when the temperature ofPTC thermistor polymer portions (1056, 1058) is below a certainthreshold and RF energy is applied to jaws, RF energy may flow throughtissue (not shown) from PTC thermistor polymer portion (1056) to PTCthermistor polymer portion (1058). It should be understood that this RFenergy flow path through tissue is oblique, similar to the oblique RFenergy path described above with respect to jaws (42, 44). RF energy mayalso flow through the tissue from electrode strip (1062) to electrodestrip (1064), which is another oblique path. Furthermore, RF energy mayalso flow through the tissue from electrode strip (1062) to PTCthermistor polymer portion (1058); and from electrode strip (1064) toPTC thermistor polymer portion (1056). It should therefore be understoodthat RF energy may flow through tissue along four different paths whenPTC thermistor polymer portions (1056, 1058) are in electricallyconductive states.

Once the temperature of PTC thermistor polymer portions (1056, 1058)exceeds the threshold, PTC thermistor polymer portions (1056, 1058)become electrically insulative. At that stage, to the extent that RFenergy continues to flow through the tissue at all, the RF energy onlyflows through the tissue from electrode strip (1062) to electrode strip(1064). In some other versions, PTC thermistor polymer portions (1056,1058) are substituted with insulative plastic. In such versions, RFenergy may simply flow through the tissue from electrode strip (1062) toelectrode strip (1064), again along an oblique path. As another merelyillustrative example, electrode strips (1062, 1064) may be omitted andRF energy may flow through tissue from PTC thermistor polymer portion(1056) to PTC thermistor polymer portion (1058) until the temperatureexceeds a threshold, at which point RF energy stops flowing through thetissue.

As noted above, I-beam knife (770) of the present example includes apair of outwardly directed upper transverse pins (772) and a pair ofoutwardly directed lower transverse pins (774). Pins (772) are disposedin a recess (1071) defined in jaw (1044); while pins (774) are disposedin a recess (1070) defined in jaw (1042). I-beam knife (770) is operableto translate longitudinally through jaws (1042, 1044). In use, jaws(1042, 1044) may be closed on tissue to compress the tissue and thenweld/seal/coagulate the tissue as described above. Then, I-beam knife(770) may be driven distally to cut the tissue. Again, several merelyillustrative examples of how I-beam knife (770) may be driven distallywill be described in greater detail below; while further examples willbe apparent to those of ordinary skill in the art in view of theteachings herein. In the event that jaws (1042, 1044) are not fullycompressing the tissue when I-beam knife (770) is driven distally, pins(772, 774) may act as cams against jaws (1042, 1044) to thereby drivejaws (1042, 1044) to fully compressed positions.

Before or after jaws (1042, 1044) are used to weld/seal/coagulate tissuecaptured between jaws (1042, 1044), and perhaps before or after tissueis severed by an I-beam knife (770), the user may rotate jaws (1042,1044) approximately ninety degrees about their longitudinal axis andpress the exterior of jaws (1042, 1044) against tissue to seal/coagulatethe tissue. In particular, the user may press exterior electrode strips(1066, 1068) against tissue, which may be energized with bipolar RFenergy to seal/coagulate the tissue along a region between the tissuecontact points of exterior electrode strips (1066, 1068). It should alsobe understood that exterior electrode strips (1066, 1068) may be used toseal/coagulate tissue in instances where neither any interior portionsof jaws (1042, 1044) are used to weld/seal/coagulate tissue nor anI-beam knife (770) (or other feature) is used to sever tissue.

V. Exemplary Jaws with Staggered Teeth

In some instances, it may be desirable to have jaws with teeth withpositioning that alternates along the length of the jaws. Suchconfigurations may provide enhanced capabilities for grasping andholding tissue between the jaws. Such configurations may also provideenhanced tissue welding/sealing/coagulating capabilities. In addition orin the alternative, such configurations may facilitate severing oftissue between jaws, such as by reducing the force needed in squeezinghandles (12, 14) to sever tissue. FIGS. 23-26 show an exemplaryvariation of jaws (1142, 1144) having teeth (1152, 1154) with positionsthat alternate along the length of jaws (1142, 1144). In particular,teeth (1152) are asymmetrically positioned opposing sides of alongitudinal line extending along the center of lower jaw (1142). Teeth(1154) are asymmetrically positioned on opposing sides of a longitudinalline extending along the center of upper jaw (1142). A series ofrecesses (1156) separate teeth (1152) along lower jaw (1142), creating acheckerboard type of pattern; while a similar series of recesses (1158)separate teeth (1154) along upper jaw (1144), also creating acheckerboard type of pattern.

As best seen in FIGS. 25-26, the spacing of teeth (1152, 1154) andrecesses (1156, 1158) is configured such that teeth (1152) nest incomplementary recesses (1158), and such that teeth (1154) nest incomplementary recesses (1156), when jaws (1142, 1144) are closedtogether. In the present example, each tooth (1152, 1154) comprises anelectrically insulative material, while recesses (1156, 1158) arepresent electrically conductive surfaces. For instance, jaws (1142,1144) may be generally formed of an electrically conductive material(e.g., metal), with teeth (1152, 1154) being formed as unitary featuresof jaws (1142, 1144), and with teeth (1152, 1154) being coated in anelectrically insulative material (e.g., plastic) leaving the conductivematerial of recesses (1156, 1158) exposed. As yet another merelyillustrative example, jaws (1142, 1144) may be generally formed of anelectrically conductive material (e.g., metal) presenting flat inner jawsurfaces, with teeth (1152, 1154) being formed entirely of electricallyinsulative material (e.g., plastic) then secured to the flat innersurfaces of jaws (1142, 1144), leaving the conductive material ofrecesses (1156, 1158) exposed. Other suitable ways in which teeth (1152,1154) may be formed will be apparent to those of ordinary skill in theart in view of the teachings herein. It should also be understood thatone or more edges of each tooth (1152, 1154) includes a pressureconcentration feature, such as a ridge, hump, raised edge, etc.

As also seen in FIGS. 25-26, the lateral interior faces (1153, 1155) ofteeth (1152, 1154) are obliquely angled, similar to regions (62, 72)described above. Recess (1156) surfaces of lower jaw (1142) have anegative bias while recess (1158) surfaces of upper jaw (1144) have apositive bias. This configuration provides an oblique lateral path forRF energy traveling from recess (1156) surface to the laterallyassociated recess (1158) surface through tissue clamped between jaws(1142, 1144). In addition, the distal faces (1172) of teeth (1152) andthe proximal faces (1174) of teeth (1152), as well as the distal faces(1176) of teeth (1154) and the proximal faces (1178) of teeth (1154),are all obliquely angled. These configurations thus provide an obliquelongitudinal path for RF energy traveling from recess (1156) surface tothe longitudinally associated recess (1158) surfaces through tissueclamped between jaws (1142, 1144). In other words, RF energy may traveldistally/proximally along oblique paths between recess (1156, 1158)surfaces and laterally along oblique paths between recess (1156, 1158)surfaces. In some other versions, teeth (1152, 1154) are spaced suchthat greater gaps are located between faces (1153, 1155), between faces(1172, 1178), and/or between faces (1174, 1176) when jaws (1142, 1144)are closed together, such that corresponding faces (1153, 1155), faces(1172, 1178), and/or faces (1174, 1176) would not tend to contact eachother when jaws (1142, 1144) are closed together. Other suitableconfigurations and arrangements for teeth (1152, 1154) will be apparentto those of ordinary skill in the art in view of the teachings herein.

Jaws (1142, 1144) further comprise a distal tooth (1162) and distaltooth nest (1164). Tooth (1162) has a triangular profile in this exampleand fits within tooth nest (1164) when jaws (1142, 1144) are closedtogether, as shown in FIG. 24. In some instances, the combination ofdistal tooth (1162) and distal tooth nest (1164) may provide greatertissue gripping control with jaws (1142, 1144) and/or fine tearingdissection capabilities, similar to a Maryland dissector, etc. Inaddition or in the alternative, the combination of distal tooth (1162)and distal tooth nest (1164) may provide opposed electrode fine cautery(e.g., as contrasted to offset electrode gross transaction cauteryprovided by teeth (1152, 1154). Of course, distal tooth (1162) anddistal tooth nest (1164) may have any other suitable configurations andcapabilities. It should also be understood that distal tooth (1162)and/or distal tooth nest (1164) may simply be omitted, if desired.

VI. Exemplary Jaws with External Blunt Dissection Features

In some settings, a user may wish to use jaws (42, 44) to perform bluntdissections. For instance, a user may wish to drive jaws (42, 44) intotissue to separate one tissue portion from another tissue portion,within the same anatomical structure. As another example, a user maywish to drive jaws (42, 44) between one anatomical structure and anadjacent anatomical structure, to effectively peel away the tissue ofone anatomical structure from the adjacent anatomical structure. Suchblunt dissection operations may be performed with jaws (42, 44) beingkept closed together. In addition, the user may perform blunt dissectionby opening jaws (42, 44) within or between tissue, such that openingjaws (42, 44) may assist in separating tissue and/or anatomicalstructures. FIGS. 27-28 show exemplary features that may be provided toenhance blunt dissection capabilities of jaws (42, 44). Other examplesof blunt dissection features will be apparent to those of ordinary skillin the art in view of the teachings herein. It should be understood thatthe blunt dissection features described herein may be readily applied toany of the jaws described herein. Furthermore, it should be understoodthat the blunt dissection features described herein may be used beforeor after the jaws are used to weld/seal/coagulate and/or sever tissue.

FIG. 27 shows a pair of jaws (1242, 1244) having respective sets ofexemplary exterior lateral wedge features (1246, 1248). Lateral wedgefeatures (1246, 1248) are formed as angled fins that define respectivelaterally opening angles. These angles all have respective vertexes thatare positioned along an axis that is parallel to and laterally offsetfrom the longitudinal axis of jaws (1242, 1244). Lateral wedge features(1246, 1248) may enhance blunt dissection capabilities when jaws (1242,1244) are moved into/between tissue along a path of movement that istransverse to the longitudinal axis of jaws (1242, 1244). When jaws(1242, 1244) are positioned in tissue or between tissue structures andjaws (1242, 1244) are then opened while being heldlaterally/longitudinally stationary, lateral wedge features (1246, 1248)may substantially prevent jaws (1242, 1244) from slipping out ofposition relative to the tissue. Lateral wedge features (1248) may alsobe used to scrape tissue and/or perform other acts. Furthermore, lateralwedge features (1246, 1248) may be used to manipulate tissue when jaws(1242, 1244) are moved into/between tissue along a path of movement thatis parallel to the longitudinal axis of jaws (1242, 1244). Othersuitable variations and uses of lateral wedge features (1246, 1248) willbe apparent to those of ordinary skill in the art in view of theteachings herein.

FIG. 28 shows a pair of jaws (1342, 1344) where upper jaw (1344) has anexterior upper crest (1348) extending longitudinally along the outersurface of upper jaw (1344). While not shown, it should be understoodthat lower jaw (1342) may also have a crest. Crest (1348) extends alongthe full length of upper jaw (1344) in this example, though it should beunderstood that crest (1348) may extend along any suitable length. Inaddition, crest (1348) extends along a path that is parallel to thelongitudinal axis of jaws (1342, 1344), though crest (1348) mayalternatively extend along any other suitable path. Crest (1348) ispointed in the present example, though crest (1348) may instead berounded or have any other suitable configuration. Other suitableconfigurations for crest (1348) will be apparent to those of ordinaryskill in the art in view of the teachings herein. It should beunderstood that crest (1348) may provide a pressure concentration regionagainst tissue, such as by concentrating a substantial amount ofpressure applied by the exterior of jaws (1342, 1344) along crest(1348). Crest (1348) may also assist in maintaining the lateralpositioning of jaws (1342, 1344) relative to tissue when jaws (1342,1344) are opened while being disposed in tissue or between tissuestructures. Crest (1348) may also be used to scrape tissue and/orperform other acts. Other suitable variations and uses of crest (1348)will be apparent to those of ordinary skill in the art in view of theteachings herein.

FIG. 29 shows a pair of jaws (1442, 1444) having respective sets ofexemplary exterior sawtooth features (1446, 1448). Sawtooth features(1446, 1448) are formed as angled teeth that define respectiveproximally opening angles. These angles all have respective vertexesthat are positioned along the longitudinal axis of jaws (1442, 1444).Sawtooth features (1446, 1448) may enhance blunt dissection capabilitieswhen jaws (1442, 1444) are moved into/between tissue along a path ofmovement that is parallel to the longitudinal axis of jaws (1442, 1444).When jaws (1442, 1444) are positioned in tissue or between tissuestructures and jaws (1442, 1444) are then opened while being heldlaterally/longitudinally stationary, sawtooth features (1446, 1448) maysubstantially prevent jaws (1442, 1444) from slipping out of positionrelative to the tissue. Sawtooth features (1446, 1448) may also be usedto scrape tissue and/or perform other acts. Furthermore, sawtoothfeatures (1446, 1448) may be used to manipulate tissue when jaws (1442,1444) are moved into/between tissue along a path of movement that istransverse to the longitudinal axis of jaws (1442, 1444). Other suitablevariations and uses of sawtooth features (1446, 1448) will be apparentto those of ordinary skill in the art in view of the teachings herein.

VII. Exemplary Forceps Controls

As noted above with respect to FIGS. 1-3, a single button (16) may beused to selectively activate electrode surfaces to deliver RF energy totissue clamped between jaws (42, 44). In some such versions, the singlebutton (16) simply turns the RF energy on, at one set of operationalparameters (e.g., frequency, amplitude, etc.), when button (16) isactuated. The RF energy simply turns off when button (16) is released.In some instances, it may be desirable to provide more than one set ofparameters for the RF energy, based on the particular operation to beperformed. For instance, tissue welding operations may warrant a firstcombination of RF energy parameters (e.g., lower amplitude, etc.) whiletissue cutting operations may warrant a second combination of RF energyparameters (e.g., higher amplitude, etc.). To that end, it may bedesirable to provide one or more user input features that are operableto selectively activate RF energy at the energy parameter combinationsthat are best suited to the task at hand. Several merely illustrativeexamples of such user input features will be described in greater detailbelow, while additional examples will be apparent to those of ordinaryskill in the art in view of the teachings herein. It should beunderstood that the below teachings may be readily combined with any ofthe above teachings in numerous permutations.

FIG. 30 shows an exemplary forceps instrument (1510) that includes apair of jaws (1542, 1544) and a pair of handles (1512, 1514) thatprovide a scissor grip. Lower handle (1512) includes a pair of texturedtrigger buttons (1516, 1518). Proximal trigger button (1516) is operableto activate electrode surfaces of jaws (1542, 1544) with RF energy at afirst combination of operational parameters; while distal trigger button(1518) is operable to activate electrode surfaces of jaws (1542, 1544)with RF energy at a second combination of operational parameters. By wayof example only, proximal trigger button (1516) may activate electrodesurfaces of jaws (1542, 1544) with RF energy at a combination ofparameters associated with tissue welding/sealing/coagulating; whiledistal trigger button (1518) may activate electrode surfaces of jaws(1542, 1544) with RF energy at a combination of parameters associatedwith tissue cutting. As shown, proximal trigger button (1516) is largerthan distal trigger button (1518), providing the user with the abilityto differentiate between trigger buttons (1516, 1518) based solely onthe sense of touch, without having to look at trigger buttons (1516,1518).

Of course, trigger buttons (1516, 1518) may take a variety ofalternative forms as will be apparent to those of ordinary skill in theart in view of the teachings herein. For instance, trigger buttons(1516, 1518) may be configured as proximally and distally positionedflexible bubbles, buttons having differing sizes, buttons havingdiffering shapes, a slider switch, a switch having a plurality ofmovable positions, buttons having different colors, or any othersuitable variations as would be apparent to one of ordinary skill in theart in view of the teachings herein. It should also be understood thatinstrument (1510) may have more than two trigger buttons (e.g., toprovide selective activation of more than two combinations of RF energyparameters, etc.). Furthermore, distal trigger button (1518) may beoperable to actuate an I-beam knife or other movable cutting feature, inaddition to or in lieu of activating RF energy at a second combinationof parameters.

FIG. 31 shows an exemplary forceps instrument (1610) that includes apair of jaws (1642, 1644), a pair of handles (1612, 1614) that provide ascissor grip, and a single textured trigger button (1616). Triggerbutton (1616) is movable proximally through a progressive series of tworanges of motion in two separate stages. In particular, trigger button(1616) is movable proximally from a distal position to a transitionposition. At this stage, trigger button (1616) activates electrodesurfaces of jaws (1642, 1644) with RF energy at a first combination ofoperational parameters. By way of example only, this first combinationof operational parameters may be associated with tissuewelding/sealing/coagulating. Trigger button (1616) is further movableproximally from the transition position to a proximal position. At thisstage, trigger button (1616) activates electrode surfaces of jaws (1642,1644) with RF energy at a second combination of operational parameters.By way of example only, this second combination of operationalparameters may be associated with tissue cutting.

It should be understood that a detent and/or other feature(s) may beused to provide the user with feedback indicating the completion of thefirst range of motion (i.e., indicating that the user has reached thetransition position). Such feedback features may provide tactile and/oraudible feedback to the user. In addition or in the alternative, a lightor other form of visual feedback may be used as a form of feedback tothe user. Of course, trigger button (1616) may take a variety ofalternative forms as will be apparent to those of ordinary skill in theart in view of the teachings herein. It should also be understood thattrigger button (1616) may have more than two activation positions withinits range of motion (e.g., to provide selective activation of more thantwo combinations of RF energy parameters, etc.). Furthermore, theproximal position of trigger button (1616) may actuate an I-beam knifeor other movable cutting feature, in addition to or in lieu ofactivating RF energy at a second combination of parameters.

It should be understood that instruments (1510, 1610) are configuredsuch that a user may readily perform separate acts of tissuewelding/sealing/coagulating and cutting using the same single finger ofthe hand that grips instrument (1510, 1610). In some instances, it maybe desirable to use separate fingers to perform the separate acts ofwelding/sealing/coagulating and cutting. FIG. 32 shows an exemplaryforceps instrument (1710) that facilitates the use of separate fingersto perform the separate acts of welding/sealing/coagulating and cutting,though it should be understood that a user may nevertheless use the samesingle finger to perform the separate acts ofwelding/sealing/coagulating and cutting with instrument (1710), ifdesired. Instrument (1710) of this example includes a pair of jaws(1742, 1744), a pair of handles (1712, 1714) that provide a scissorgrip, a distal trigger button (1716), and a proximal pivoting trigger(1718). As shown, distal trigger button (1716) is positioned to beactuated by the user's index finger; while proximal pivoting trigger(1718) is positioned to be actuated by the middle finger of the samehand. Proximal pivoting trigger (1718) is configured to pivot relativeto handle (1712) at a pivotal coupling (1720).

Distal trigger button (1716) is operable to activate electrode surfacesof jaws (1742, 1744) with RF energy at a first combination ofoperational parameters; while proximal pivoting trigger (1718) isoperable to activate electrode surfaces of jaws (1742, 1744) with RFenergy at a second combination of operational parameters. By way ofexample only, distal trigger button (1716) may activate electrodesurfaces of jaws (1742, 1744) with RF energy at a combination ofparameters associated with tissue welding/sealing/coagulating; whileproximal pivoting trigger (1718) may activate electrode surfaces of jaws(1742, 1744) with RF energy at a combination of parameters associatedwith tissue cutting. It should be understood that proximal pivotingtrigger (1718) may be operable to actuate an I-beam knife or othermovable cutting feature, in addition to or in lieu of activating RFenergy at a second combination of parameters.

FIGS. 33A-33C show an exemplary forceps instrument (1810) with handles(1812, 1814) and jaws (1842, 1844) that are operable to clamp and sealtissue. Instrument (1810) of this example further comprises a triggermember (1816) that is operable to control energization of jaws (1842,1844) and that is also operable to restrict movement of jaws (1842,1844). Trigger member (1816) is pivotally coupled with handle (1812) bya pin (1824); and is pivotable relative to handle (1812) about pin(1824). Trigger member (1816) also comprises a button (1820) that may bepressed by a user. Button (1820) is operable to activate electrodesurfaces of jaws (1842, 1844) with RF energy as described above, tothereby weld/seal/coagulate tissue captured between jaws (1842, 1844).

An upper portion of trigger member (1816) includes a seat (1822) that isshaped to complement the underside of upper handle (1814). Triggermember (1816) is pivotable about pin (1824) through the range of motiondepicted in FIGS. 33A-33C. In particular, when trigger member (1816) isin the generally upright position, trigger member (1816) enables handles(1812, 1814) to be partially pivoted toward each other as shown in thetransition from FIG. 33A to FIG. 33B. This provides partial closure ofjaws (1842, 1844). When handles (1812, 1814) and jaws (1842, 1844) reachthe position shown in FIG. 33B, handle (1814) is received in seat (1822)and trigger member (1816) blocks further pivoting of handles (1812,1814) and jaws (1842, 1844). The length of trigger member (1816) isselected to provide a particular gap between jaws (1842, 1844) at thisstage. This gap is associated with a degree of tissue compressionassociated with tissue welding/sealing/coagulating. For instance, thisgap may be similar to the distance between jaws (342, 344) shown in FIG.10B. At this stage, the user may depress button (1820) to activateelectrode surfaces of jaws (1842, 1844) with RF energy to therebyweld/seal/coagulate tissue captured between jaws (1842, 1844).

After the user has depressed button (1820) to activate electrodesurfaces of jaws (1842, 1844) with RF energy as described above, and thetissue between jaws has been sufficiently welded/sealed/coagulated, theuser may press on trigger member (1816) with additional force to pivottrigger member (1816) from the position shown in FIG. 33B to theposition shown in FIG. 33C. This moves seat (1822) out of engagementwith upper handle (1814), providing clearance for handles (1812, 1814)to be drawn closer together, thereby enabling jaws (1842, 1844) to bedriven further toward each other. In particular, the user may now drivejaws (1842, 1844) toward each other with sufficient distance and forceto sever tissue captured between jaws (1842, 1844). For instance, withtrigger member (1816) pivoted from the position shown in FIG. 33B to theposition shown in FIG. 33C, jaws (1842, 1844) may reach a positionsimilar to the positioning of jaws (342, 344) shown in FIG. 10C. Itshould be understood from the foregoing that trigger member (1816) maybe used to ensure that tissue is suitably welded/sealed/coagulatedbefore the tissue is cut. In other words, the temporary arrest of upperhandle (1814) by trigger member (1816) may remind the user to activatebutton (1820), to thereby weld/seal/coagulate the tissue, beforecompleting the act of cutting the tissue. In the present example,trigger member (1816) is resiliently biased to the position shown inFIG. 33A, to thereby block full closure of jaws (1842, 1844) by default.

FIGS. 34A-34C show yet another exemplary forceps instrument (1910)having jaws (1942, 1944) and handles (1912, 1914). Instrument (1910)further comprises a trigger (1916) with a button (1920). Trigger (1916)is positioned within a slot (1922) of handle (1912) such that trigger(1916) is slidable within slot (1922). FIG. 34B shows handles (1912,1914) urged toward each other to close jaws (1942, 1944); and button(1920) depressed. Button (1920) is operable to activate electrodesurfaces of jaws (1942, 1944) with RF energy, to weld/seal/coagulatetissue captured between jaws (1942), when button (1920) is depressed asshown in FIG. 34B. Instrument (1910) of this example further comprises apivoting knife (1970). Knife (1970) comprises a blade that is configuredto pass through a longitudinally extending slot formed in upper jaw(1944), such that knife (1970) is pivotable from an upper position (FIG.34B) to a lower position (FIG. 34C). Knife (1970) is pivotally coupledat the same joint (1980) that couples jaws (1942, 1944) and handles(1912, 1914) in this example, though it should be understood that aseparate coupling may be used.

The proximal end of knife (1970) presents a lever arm (1971) that isengaged by trigger (1916). In particular, as trigger (1916) is pushedupwardly relative to handle (1912), trigger (1916) pushes upwardly onlever arm (1971). Due to the pivot provided at joint (1980), this upwardmovement of lever arm (1971) provides downward movement of the blade ofknife (1970) as seen in the transition from FIG. 34B to FIG. 34C. Thisdownward movement of the blade of knife (1970) severs tissue capturedbetween jaws (1942, 1944). In some versions, lower jaw (1942) provides acutting board against which the blade of knife (1970) acts in order tosever tissue captured between jaws (1942, 1944). In the present example,spring biases are selected such that the amount of force required tomove button (1920) from the position shown in FIG. 34A to the positionshown in FIG. 34B is substantially less than the amount of forcerequired to move trigger (1916) from the position shown in FIGS. 34A-34Bto the position shown in FIG. 34C. Thus, when a user presses upwardly onbutton (1920) and trigger (1916), button (1920) will be fully depressedbefore trigger (1916) moves within slot (1922), such that the electrodesurfaces of jaws (1942, 1944) will provide bipolar RF energy to tissuecaptured between jaws (1942, 1944) before knife (1970) severs thattissue.

In the example shown in FIGS. 34A-34C, knife (1970) is actuated bypushing trigger (1916) along a path that is generally transverse tohandle (1912). In some other versions, a trigger is pushed along a paththat is generally parallel to a handle in order to actuate a knife. Forinstance, FIGS. 35-36B show an exemplary forceps instrument (2010) witha pair of handles (2012, 2014), a pair of jaws (2042, 2044), and alongitudinally sliding trigger (2016). Instrument (2010) also includes aknife (2070) having a sharp edge (2071) that is operable to sever tissueclamped between jaws (2042, 2044). Knife (2070) of this example furtherincludes a pair of laterally extending pins (2022) and a proximalengagement leg (2024). Pins (2022) are disposed in obliquely angledslots (2020) that are formed in upper jaw (2044). The configuration ofslots (2020) and the relationship between slots (2020) and pins (2022)provide movement of knife (2070) along a vertical plane when knife(2070) is driven distally/proximally. In particular, knife (2070) willmove downwardly when knife (2070) moves from a distal position to aproximal position; and will move upwardly when knife (2070) moves from aproximal position to a distal position. FIG. 36A shows knife (2070) inan upper, distal position. FIG. 36B shows knife (2070) in a lower,proximal position, which is where knife (2070) would be severing tissuecaptured between jaws (2042, 2044).

As shown in FIG. 35, proximal engagement leg (2024) of knife (2070) iscoupled with trigger (2016). Trigger (2016) is slidable proximallyrelative to handle (2012). Thus, a user may pull trigger (2016)proximally relative to handle (2012) to pull knife (2070) proximally,thereby driving knife (2070) downwardly to sever tissue. Trigger (2016)of the present example is resiliently biased distally, thereby biasingknife (2070) to the upper position shown in FIG. 36A. It should beunderstood that trigger (2016) may include an activation feature similarto button (1920) described above, to selectively activate electrodesurfaces of jaws (2042, 2044) with bipolar RF energy. Such a button maybe configured for staged actuation with trigger (2016) such that RFenergy is applied to tissue before the tissue is severed by knife(2070).

FIGS. 35-36B show an exemplary alternative version of a forcepsinstrument (2010) having an alternative way of using a knife (2070) tocut tissue clamped between jaws (2042, 2044). Jaw (2044) comprises a camfeature (2022) operable to engage cam slots (2020) of knife (2070).Knife (2070) has a shape that generally follows the contour of jaw(2044) in an angular fashion. Knife (2070) further comprises anengagement leg (2024) operable to engage trigger (2016). In particular,trigger (2016) may be actuated by a user to move knife (2070) from theposition shown in FIG. 36A to the position of knife (2070) shown in FIG.36B. Trigger (2016) moves proximally against engagement leg (2024) whichpulls knife (2070) proximally. As knife (2070) moves proximally, knife(2070) also slices downward such that any tissue between jaws (2042,2044) would be cut by knife (2070). It will be understood that in someversions, knife (2070) may be spring biased to assume the position shownin FIG. 36A.

FIGS. 37-38E show another exemplary alternative version of a forcepsinstrument (2110) along with features to energize and cut tissue.Instrument (2110) of this example comprises a pair of handles (2112,2114) and a corresponding pair of jaws (2142, 2144) that are operable toclamp and energize tissue that is captured between jaws (2142, 2144).Instrument (2110) further comprises a trigger (2116) that is incommunication with a coupler (2118) and that is operable to move alonghandles (2112, 2114) with coupler (2118). As best seen in FIG. 37,coupler (2118) defines a channel (2124) and a coupling arm (2126).Handle (2114) is slidably disposed in channel (2124) such that coupler(2118) can slide along handle (2114). Coupling arm (2126) is coupledwith trigger (2116) such that when a user presses trigger (2116),coupler (2118) slides along handle (2114). It will be appreciated thatcoupler (2118) and trigger (2116) may be biased to assume the positionshown in FIG. 38A.

Handle (2114) of the present example comprises a pair of segments thatare joined at a joint (2120) and that are operable to pivot relative toeach other at joint (2120). Handle (2114) further comprises a pivotinglink (2122) that is in pivotal communication with a translating knife(2170), such that link (2122) is operable to advance knife (2170)distally in response to handle (2114) pivoting toward handle (2112).FIG. 38B shows handle (2114) pivoted to a position where jaws (2142,2144) are fully closed and are thereby positioned to clamp tissue. Itshould be noted that coupler (2118) is positioned over joint (2120)during the transition from FIG. 38A to FIG. 38B, and thereby preventsthe segments of handle (2114) from pivoting at joint (2120). In otherwords, coupler (2118) keeps handle (2114) substantially straight duringthe transition from FIG. 38A to FIG. 38B.

After jaws (2142, 2144) have clamped on tissue, trigger (2116) may thenbe actuated distally, as seen in FIG. 38C, to apply bipolar RF energy tojaws (2142, 2144) to weld/seal/coagulate the tissue. The distallypositioned trigger (2116) also locks jaws (2142, 2144) together in theclosed position. When trigger (2116) is actuated distally, coupler(2118) is also slid distally along handle (2114), such that coupler(2118) no longer encompasses joint (2120). With coupler (2118) in adistal position and with joint (2120) being effectively freed, the usermay then squeeze handles (2112, 2114) further toward each other, therebypivoting the proximal segment of handle (2114) relative to the distalsegment of handle (2112) at joint (2120). This further pivoting of theproximal segment of handle (2114) drives the distal end of link (2122)distally, which in turn drives knife (2170) distally to sever tissuecaptured between jaws (2142, 2144). Knife (2170) may have an I-beamconfiguration or any other suitable configuration. After tissue has beensevered, the user may release handle (2114) and pull trigger (2116) backproximally, resetting instrument (2110) to the position shown in FIG.38E.

The forceps instrument (2210) shown in FIGS. 39-40B combines features offorceps instrument (1810) of FIGS. 33A-33C with features of forcepsinstrument (1910) of FIGS. 34A-34C. In particular, instrument (2210) ofthis example includes handles (2212, 2214), jaws (2242, 2244), apivoting trigger member (2216), and a pivoting knife (2270). Triggermember (2216) is pivotally coupled with handle (2212) by a pin (2217)and is operable to selectively restrict movement of jaws (2242, 2244) byselectively arresting movement of handle (2212) toward handle (2214).While not depicted in FIGS. 39-40B, it should be understood that triggermember (2216) may also include a feature similar to button (1820)described above, which may selectively activate electrode surfaces ofjaws (2242, 2244) with RF energy as described above, to therebyweld/seal/coagulate tissue captured between jaws (2242, 2244).

An upper portion of trigger member (2216) includes a seat (2220) that isshaped to complement the underside of upper handle (2214). Triggermember (2216) is pivotable about pin (2217) through the range of motiondepicted in FIGS. 40A-40B. In particular, when trigger member (2016) isin the generally upright position, trigger member (2216) enables handles(2212, 2214) to be partially pivoted toward each other as shown in thetransition from FIG. 39 to FIG. 40A. This provides partial closure ofjaws (2242, 2244). When handles (2212, 2214) and jaws (2242, 2244) reachthe position shown in FIG. 40A, handle (2214) is received in seat (2220)and trigger member (2216) blocks further pivoting of handles (2212,2214) and jaws (2242, 2244). The length of trigger member (2216) isselected to provide a particular gap between jaws (2242, 2244) at thisstage. This gap is associated with a degree of tissue compressionassociated with tissue welding/sealing/coagulating. For instance, thisgap may be similar to the distance between jaws (342, 344) shown in FIG.10B. At this stage, the user may activate electrode surfaces of jaws(2242, 2244) with RF energy to thereby weld/seal/coagulate tissuecaptured between jaws (2242, 2244).

After the user has activated electrode surfaces of jaws (2242, 2244)with RF energy as described above, and the tissue between jaws has beensufficiently welded/sealed/coagulated, the user may press on triggermember (2216) to pivot trigger member (2216) from the position shown inFIG. 40A to the position shown in FIG. 40B. This moves seat (2220) outof engagement with upper handle (2214), providing clearance for handles(2212, 2214) to be drawn closer together, thereby enabling jaws (2242,2244) to be driven further toward each other. This additional clearancealso enables upper handle (2214) to actuate pivoting knife (2270) aswill be described in greater detail below.

Knife (2270) of the present example comprises a blade that is configuredto pass through a longitudinally extending slot formed in upper jaw(2244), such that knife (2270) is pivotable from an upper position (FIG.40A) to a lower position (FIG. 40B). Knife (2270) is pivotally coupledat the same joint (2280) that couples jaws (2242, 2244) and handles(2212, 2214) in this example, though it should be understood that aseparate coupling may be used. The proximal end of knife (2270) presentsa lever arm (2271) that is engaged by an actuation arm (2218), which ispivotally secured to lower handle (2212). Actuation arm (2218) is bentat an obtuse angle in this example, with a distal portion contacting theunderside of lever arm (2271). The proximal portion of actuation arm(2218) is positioned for engagement by a protrusion (2215) of upperhandle (2214). In particular, as upper handle (2214) is pivoted from theposition shown in FIG. 40A to the position shown in FIG. 40B, protrusion(2215) drives the proximal portion of actuation arm (2218) downwardly.This causes the distal portion of actuation arm (2218) to pivotupwardly, which in turn drives lever arm (2271) of knife (2270)upwardly. This upward movement of lever arm (2271) provides downwardmovement of the blade of knife (2270) as seen in the transition fromFIG. 40A to FIG. 40B. This downward movement of the blade of knife(2270) severs tissue captured between jaws (2242, 2244). In someversions, lower jaw (2242) provides a cutting board against which theblade of knife (2270) acts in order to sever tissue captured betweenjaws (2242, 2244).

FIGS. 41-42C show yet another exemplary version of a forceps instrument(2310) operable to prevent inadvertent actuation of a knife (2370).Instrument (2310) of this example comprises handles (2312, 2314) andjaws (2342, 2344). Knife (2370) extends longitudinally through a shaft(2313) and is operable to advance distally to cut tissue clamped inbetween jaws (2342, 2344). The distal portion of knife (2370) has anI-beam configuration in this example, though it should be understoodthat any other suitable configuration may be used. Handle (2314) has abent distal portion (2320) that is pivotally coupled with a link (2322),which is further pivotally coupled with the proximal end of knife(2370). Instrument (2310) further comprises a trigger (2316) that isoperable to selectively prevent movement of handle (2314) toward handle(2312). In particular, and as best seen in FIG. 42A, a stem (2317) oftrigger (2316) engages a notch (2318) formed in distal portion (2320) ofhandle (2314), such that trigger (2316) is operable to block movement ofhandle (2314).

As shown in FIG. 42B, trigger (2316) may be pivoted to disengage stem(2317) from notch (2318), to thereby release handle (2314). With handle(2314) released from trigger (2316), the user may pivot handle (2314)toward handle (2312), as also shown in FIG. 42B. This movement of handle(2312) drives knife (2370) distally via link (2322). Knife (2370) hasupper and lower flanges (2371, 2373) that interact with jaws (2342,2344) to drive upper jaw (2344) toward lower jaw (2342), such that jaws(2342, 2344) close in response to distal advancement of knife (2370).Jaws (2342, 2344) and knife (2370) may thus clamp and sever tissue asknife (2370) is driven distally. In some versions, jaws (2342, 2344)also include electrode surfaces that are operable to deliver bipolar RFenergy to tissue clamped between jaws (2342, 2344), to therebyweld/seal/coagulate the tissue. By way of example only, an RF activationbutton may be incorporated into trigger (2316) and/or elsewhere withininstrument (2310). After (2310) instrument has performed the desiredoperations on tissue, the user may release trigger (2316) to theoriginal position shown in FIG. 41. This pulls knife (2370) backproximally, ultimately opening jaws (2342, 2344) back up as shown inFIG. 42C. If desired, the user may pivot trigger (2316) to re-engagestem (2317) in notch (2318), to thereby re-lock handle (2314) as shownin FIG. 42A.

FIGS. 43A-43D show another exemplary forceps instrument (2410) havingjaws (2442, 2444) and handles (2412, 2414). A knife (2470) is operableto advance distally through handle (2412) to cut tissue clamped betweenjaws (2442, 2444). The distal portion of knife (2470) has an I-beamconfiguration in this example, though it should be understood that anyother suitable configuration may be used. Knife (2470) is pivotallycoupled with a link (2422), which is further pivotally coupled withhandle (2414). A trigger (2416) is operable to selectively block distalmovement of knife (2470). In particular, trigger (2416) is configured toselectively engage a lateral notch (2424) formed in knife (2470). Whentrigger (2416) engages notch (2424), knife (2470) is unable to movedistally. When trigger (2416) is disengaged from notch (2424), knife(2470) is free to move distally.

FIG. 43A shows jaws (2442, 2444) open. The user closes jaws (2442, 2444)by squeezing handles (2412, 2414) together as seen in FIG. 43B. As knife(2470) closes into handle (2412), trigger (2416) engages notch (2424) ofknife (2470) such that knife (2470) cannot advance. Jaws (2442, 2444)clamp on tissue that might be positioned between jaws (2442, 2444). Theuser may then activate electrode surfaces that are operable to deliverbipolar RF energy to tissue clamped between jaws (2442, 2444), tothereby weld/seal/coagulate the tissue. By way of example only, an RFactivation button may be incorporated into trigger (2416) and/orelsewhere within instrument (2410). Regardless of whether pullingtrigger (2416) activates electrode surfaces, the user may pull trigger(2416) to disengage trigger (2416) from notch (2424) of knife (2470), asshown in FIG. 43C. With trigger (2416) disengaged from notch (2424), theuser may complete the pivoting of handle (2414) toward handle (2412),thereby driving knife (2470) distally via link (2422), as shown in FIG.43D. This distal advancement of knife (2470) severs tissue capturedbetween jaws (2442, 2444).

FIGS. 44A-44B show an alternative assembly that may be used toselectively prevent distal advancement of a knife. In particular, FIGS.44A-44B show a knife (2570) having an I-beam distal end configurationand a lateral notch (2572). A pin (2574) is operable to selectivelyengage notch (2572), to thereby selectively prevent knife (2570) frombeing advanced distally. Pin (2574) is secured to the distal end of anelectroactive laminate (2550), which is coupled with a pair of wires(2546, 2548).

In some versions, electroactive laminate (2550) comprises a layer ofheat sensitive material that expands or contracts in response to heat,with the heat being generated when a current is communicated throughwires (2546, 2548). In some other versions, electroactive laminate(2550) comprises a layer of electroactive polymer that expands orcontracts in response to current being communicated through wires (2546,2548). Other suitable materials and constructions for electroactivelaminate (2550) will be apparent to those of ordinary skill in the artin view of the teachings herein. As can be seen in FIG. 44B, passingcurrent through wires (2546, 2548) causes electroactive laminate (2550)to bend, driving pin (2574) out of engagement with notch (2572), therebyfreeing knife (2570) to translate distally. It should be understood thatthis configuration (and variations thereof) may be used in any of theexamples described herein with movable knives. It should also beunderstood that a logic circuit may be provided to prevent current fromflowing through wires (2546, 2548) until electrodes have applied bipolarRF energy to tissue. By way of example only, the circuit may preventcurrent from flowing through wires (2546, 2548) until an impedance valueassociated with the tissue reaches a level indicating sufficientwelding/sealing of the tissue by the RF energy. Other suitablevariations will be apparent to those of ordinary skill in the art inview of the teachings herein.

FIGS. 45-46 show yet another exemplary forceps instrument (2610) withjaws (2642, 2644) and handles (2612, 2614) and a mechanism forcontrolling the advancement of a knife (2670). Instrument (2610)comprises knife (2670) that is operable to advance within a handle(2612) and that has a distal end with an I-beam configuration. Handle(2614) comprises a rack (2620) engaged with a pair of pinions (2622),which are further engaged with rack teeth (2672) on knife (2670). Whenhandle (2614) is squeezed downward toward handle (2612), rack (2620)moves downward to rotate pinions (2622) and thereby advance knife (2670)distally as seen in FIG. 46. However, the advancement of knife (2670) isselectively prevented using a spring biased trigger (2616) with a latch(2618) that is operable to engage a receiving latch (2674) at theproximal end of knife (2670). The positioning and configuration oflatches (2618, 2674) prevents knife (2670) from advancing distally whenlatches (2618, 2674) are engaged. Latches (2618, 2674) may be disengagedby a user depressing trigger (2616), such that the user must holdtrigger (2616) in a depressed position in order to advance knife (2670)distally. A spring (2617) biases latch (2618) into engagement with latch(2674). By way of example only, an RF activation button may beincorporated into trigger (2616) and/or elsewhere within instrument(2610), to provide activation of electrode surfaces that are operable todeliver bipolar RF energy to tissue clamped between jaws (2642, 2644),to thereby weld/seal/coagulate the tissue.

FIGS. 47A-47B show yet another exemplary version of a forceps instrument(2710) with jaws (2742, 2744) and handles (2712, 2714) and a mechanismfor controlling the advancement of a knife (not shown). In particular,handle (2714) is in communication with a link (2722) that is operable toengage a notch (2724) of handle (2712). Engagement between link (2722)and (2724) may provide added stability for the user to slide knifebutton (2772) as seen in FIG. 47B. While knife button (2772) is shown asa slider switch in the exemplary version, it will be appreciated thatknife button (2772) may comprise any suitable switch as will be apparentto one of ordinary skill in the art in view of the teachings herein.Actuating knife button (2772) is operable to advance a curved bladethrough handle (2714) to cut tissue between jaws (2742, 2744). In someversions, handle (2714) is at least partially flexible to facilitateadvancement of the knife. A trigger (2716) is operable to selectivelyactivate exposed electrode surfaces in jaws (2742, 2744) to deliverbipolar RF energy to tissue clamped between jaws (2742, 2744), tothereby weld/seal/coagulate the tissue.

FIG. 48 shows yet another exemplary version of a forceps instrument(2810) with jaws (2842, 2844) and handles (2812, 2814) and a mechanismfor controlling the advancement of a knife (2870). Instrument (2810)includes a handle trigger (2816) that is actuated by closing handle(2814) against handle (2812). As seen in FIG. 49A, trigger (2816) formsa passageway (2818) for knife (2870) to pass through. A spring (2820)biases trigger (2816) to an upward position, as best seen in FIG. 49A.In this position, trigger (2816) is disposed in a lateral notch (2871)formed in knife (2870). This engagement prevents knife (2870) frommoving longitudinally. When handle (2814) is closed against handle(2812) to close jaws (2842, 2844), handle (2814) eventually drivestrigger (2816) downwardly, against the bias of spring (2820). As shownin FIG. 49B, this disengages trigger (2816) from lateral notch (2871)and enables knife (2870) to travel distally. In some versions, knife(2870) is resiliently biased distally such that knife (2870) willtranslate distally as soon as trigger (2816) is disengaged from lateralnotch (2871). In some other versions, a separate actuator is used todrive knife (2870) distally. In addition to effectively unlocking knife(2870), trigger (2816) also closes an electrical switch when trigger(2816) is driven to the downward position shown in FIG. 49B. Inparticular, this completes an electrical circuit that activates exposedelectrode surfaces in jaws (2842, 2844) to deliver bipolar RF energy totissue clamped between jaws (2842, 2844), to thereby weld/seal/coagulatethe tissue. Alternatively, a separate activation feature may be used tocomplete the circuit.

FIG. 50 shows yet another exemplary version of a forceps instrument(2910) with jaws (2942, 2944) and handles (2912, 2914) and a mechanismfor controlling the advancement of a knife (2970). Knife (2970) has adistal end with an I-beam configuration and a proximal end with a drivefeature (2971) that is engaged with a gear (2926). Gear (2926) iscoupled with a drive shaft (2930) of a motor (2928). Thus, motor (2928)is operable to drive knife (2970) distally to sever tissue clampedbetween jaws (2942, 2944). Handle (2912) includes a trigger (2916) thatis operable to both activate motor (2928) and activates exposedelectrode surfaces in jaws (2942, 2944) to deliver bipolar RF energy totissue clamped between jaws (2942, 2944), to thereby weld/seal/coagulatethe tissue. In this example, trigger (2916) is configured to providetwo-stage actuation, similar to trigger button (1616) described above,such that trigger (2916) is operable to activate the bipolar RFelectrodes when trigger (2916) is actuated to a first position, and suchthat trigger (2916) is operable to activate motor (2928) when trigger(2916) is actuated to a second position. Of course, any other suitableuser input feature(s) may be provided.

Handle (2912) also includes a stopper (2920) that is positioned toarrest pivoting of handle (2914) toward handle (2912). In particular, arotary cam (2922) is positioned under stopper (2920) and is operable toeither hold stopper (2920) in the upper position or allow stopper (2920)to travel downwardly, depending on the rotational position of cam(2922). A motor (2924) is operable to selectively rotate cam (2922).Motor (2924) is in communication with the same circuit as trigger(2916). A control logic is configured to activate motor (2924) inresponse to one or more conditions. In some versions, motor (2924) isactivated when trigger (2916) is actuated to the second position. Inaddition or in the alternative, a control logic may activate motor(2924) only when an impedance value associated with the tissue reaches alevel indicating sufficient welding/sealing of the tissue by the RFenergy after trigger (2916) reaches the second position. Other suitableconditions for activating motor (2924) will be apparent to those ofordinary skill in the art in view of the teachings herein. It should beunderstood that, when stopper (2920) is in the upper position, jaws(2942, 2944) may only travel to a partially closed position due to theinability of handle (2914) to fully pivot toward handle (2912). Even inthis partially closed position, jaws (2942, 2944) clamp down on tissueenough to weld/seal/coagulate the tissue. However, the merely partialclosing of jaws (2942, 2944) will prevent knife (2970) from being ableto translate distally through jaws (2942, 2944). In other words, jaws(2942, 2944) must be fully closed in order for knife (2970) to translatedistally in this example, and full closure of jaws (2942, 2944) is onlypossible when stopper (2920) is in the downward position.

VIII. Exemplary Energy Control Features

In the examples described above, a trigger, button, or other type ofuser input feature is used to selectively activate exposed electrodesurfaces in jaws to deliver bipolar RF energy to tissue clamped betweenthe jaws, to thereby weld/seal/coagulate the tissue. In some instances,these user input features may be actuated before the jaws aresufficiently closed on tissue. It may therefore be desirable in someinstances to provide a circuit feature that requires the jaws to beclosed to a certain degree before the RF energy may be delivered to theelectrode surfaces in the jaws. Several examples of such features willbe described in greater detail below, while additional examples will beapparent to those of ordinary skill in the art in view of the teachingsherein. It should be understood that the below features may be used inaddition to or in lieu of a trigger, button, or other type of user inputfeature. In other words, the below features may be used to provideautomatic activation of electrodes upon sufficient closure of jaws(e.g., such that a trigger, button, or other user input feature isomitted); or to provide a circuit lockout or safety switch that rendersa trigger, button, or other type of user input feature inoperable untilthe jaws are sufficiently closed. Various suitable ways in which thebelow teachings may be incorporated into the numerous instrumentsdescribed above will be apparent to those of ordinary skill in the artin view of the teachings herein.

FIG. 51A shows an exemplary version of a forceps instrument (3010) withjaws (3042, 3044) and handles (3012, 3014) and a mechanism forcontrolling the flow of electricity through instrument (3010). A firstwire (3046) is in communication with one or more electrode surfaces injaw (3044); while a second wire (3048) is in electrical communicationwith one or more electrode surfaces in jaw (3042). A third wire (3050)and first wire (3046) are in communication with a power source (notshown). Third wire (3050) is also in communication with a firstratcheting contact pad (3018) of handle (3012); while second wire (3048)is in communication with a second ratcheting contact pad (3020) ofhandle (3014). First pad (3018) and second pad (3020) are configured toratchet together as handles (3012, 3014) are pivoted toward each otherto close jaws (3042, 3044). When pads (3018, 3020) are coupled together,pads (3018, 3020) complete an electrical path between second wire (3048)and third wire (3050), thereby coupling second wire (3048) with thepower source. With first and second wires (3046, 3048) being coupledwith the power source, the power source is operable to deliver bipolarRF energy to wires (3046, 3048), to thereby weld/seal/coagulate tissueclamped between jaws (3042, 3044).

FIG. 52 shows yet another exemplary version of a portion of handles(3112, 3114) having a slip ring (3120) to prevent the flow of energyunless handles (3112, 3114) are closed. In particular, insulated wire(3122) is broken at slip ring (3120) until handle (3114) closes intoslip ring (3120). It will be appreciated that either of handles (3112,3114) may house the active wire while the other may house the returnwire.

FIGS. 53A-53B show yet another version of jaws (3242, 3244) with aportion of handles (3212, 3214). Wires (3246, 3248) are in communicationwith a power source and are thereby operable to deliver bipolar RFenergy to jaws (3242, 3244). A spring contact (3220) is operable toselectively provide electrical communication to jaw (3244) by openingwire (3246) when in the position shown in FIG. 53A. As handles (3212,3214) and jaws (3242, 3244) close, spring contact (3220) also closes,allowing energy to be delivered to jaw (3244) as shown in FIG. 53B. Itwill be appreciated that other suitable ways of regulating the flow ofelectricity to jaws (3242, 3244) may be used as would be apparent to oneof ordinary skill in the art in view of the teachings herein.

IX. Miscellaneous

It should be understood that any of the versions of instrument (10)described herein may include various other features in addition to or inlieu of those described above. By way of example only, any of thedevices herein may also include one or more of the various featuresdisclosed in any of the various references that are incorporated byreference herein. In addition or in the alternative, any of the devicesherein may also include one or more of the various features disclosed inU.S. Provisional Application Ser. No. 61/641,443, entitled“Electrosurgical Device for Cutting and Coagulating,” filed May 2, 2012,the disclosure of which is incorporated by reference herein. Varioussuitable ways in which such teachings may be combined will be apparentto those of ordinary skill in the art in view of the teachings herein.

It should also be understood that any of the devices described hereinmay be modified to include a motor or other electrically powered deviceto drive an otherwise manually moved component. Various examples of suchmodifications are described in U.S. Pub. No. 2012/0116379, entitled“Motor Driven Electrosurgical Device with Mechanical and ElectricalFeedback,” published May 10, 2012, now U.S. Pat. No. 9,161,803, issuedon Oct. 20, 2015, the disclosure of which is incorporated by referenceherein. Various other suitable ways in which a motor or otherelectrically powered device may be incorporated into any of the devicesherein will be apparent to those of ordinary skill in the art in view ofthe teachings herein.

It should also be understood that any of the devices described hereinmay be modified to contain most, if not all, of the required componentswithin the medical device itself. More specifically, the devicesdescribed herein may be adapted to use an internal or attachable powersource instead of requiring the device to be plugged into an externalpower source by a cable. Various examples of how medical devices may beadapted to include a portable power source are disclosed in U.S.Provisional Application Ser. No. 61/410,603, filed Nov. 5, 2010,entitled “Energy-Based Surgical Instruments,” the disclosure of which isincorporated by reference herein. Various other suitable ways in which apower source may be incorporated into any of the devices herein will beapparent to those of ordinary skill in the art in view of the teachingsherein.

While the examples herein are described mainly in the context ofelectrosurgical instruments, it should be understood that variousteachings herein may be readily applied to a variety of other types ofdevices. By way of example only, the various teachings herein may bereadily applied to other types of electrosurgical instruments, tissuegraspers, tissue retrieval pouch deploying instruments, surgicalstaplers, surgical clip appliers, ultrasonic surgical instruments, etc.It should also be understood that the teachings herein may be readilyapplied to any of the instruments described in any of the referencescited herein, such that the teachings herein may be readily combinedwith the teachings of any of the references cited herein in numerousways. Other types of instruments into which the teachings herein may beincorporated will be apparent to those of ordinary skill in the art.

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by a userimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

We claim:
 1. An apparatus comprising: (a) a body; and (b) an endeffector positioned distal to the body, wherein the end effectorcomprises: (i) a first jaw having a first grasping surface, the firstgrasping surface comprising a first electrode surface and a downwardlyfacing protrusion, wherein the downwardly facing protrusion comprises afirst PTC thermistor material, and (ii) a second jaw having a secondgrasping surface, the second grasping surface comprising a secondelectrode surface and an upwardly facing protrusion laterally offsetfrom the downwardly facing protrusion of the first grasping surface,wherein the upwardly facing protrusion comprises a second PTC thermistormaterial, wherein the first jaw and the second jaw are configured totransition between an open position, a first closed position, a secondclosed position, and a third closed position, wherein the first jaw andthe second jaw are closer together in the second closed position ascompared to the first closed position, wherein the first jaw and thesecond jaw are closer together in the third closed position as comparedto the second closed position, wherein the first jaw and the second jaware operable to grasp tissue in the first closed position, wherein thefirst electrode surface and the second electrode surface are operable totransmit bipolar RF energy to tissue grasped between the first jaw andthe second jaw in the second closed position, wherein the downwardlyfacing protrusion and the upwardly facing protrusion are configured tocooperatively sever tissue captured between the first jaw and the secondjaw in the third closed position, wherein at least one of the downwardlyfacing protrusion or the upwardly facing protrusion is configured tocontact only a portion of the second electrode surface or the firstelectrode surface, respectively, in the third closed position, whereinthe first PTC thermistor material is configured to contact the portionof the second electrode surface in the third closed position, whereinthe second PTC thermistor material is configured to contact the portionof the first electrode surface in the third closed position, wherein thefirst PTC thermistor material and the second PTC thermistor materialdefine a lateral gap in the third closed position, wherein the firstelectrode surface and the second electrode surface extend along thelateral gap in the third closed position.
 2. The apparatus of claim 1,wherein the upwardly facing protrusion comprises a hump.
 3. Theapparatus of claim 1, wherein the upwardly facing protrusion comprises aridge.
 4. The apparatus of claim 3, wherein the ridge comprises arounded profile.
 5. The apparatus of claim 3, wherein the ridgecomprises a square profile.
 6. The apparatus of claim 3, wherein theridge comprises a triangular profile.
 7. The apparatus of claim 1,wherein the body comprises a first handle and a second handle, whereinthe first and second handles are pivotally coupled together, wherein thefirst and second handles are operable to drive the first and second jawsto transition between the open position, the first closed position, thesecond closed position, and the third closed position.
 8. The apparatusof claim 1, wherein the upwardly facing protrusion is in direct contactwith the first grasping surface in the third closed position, whereinthe upwardly facing protrusion is not in direct contact with the firstgrasping surface in the second closed position.
 9. The apparatus ofclaim 1, wherein the first electrode surface extends laterally away fromthe downwardly presented protrusion toward the upwardly presentedprotrusion.
 10. The apparatus of claim 9, wherein the second electrodesurface extends laterally away from the upwardly presented protrusiontoward the downwardly presented protrusion.
 11. The apparatus of claim10, wherein the first electrode surface and the second electrode surfaceare operable to transmit bipolar RF energy to tissue in the third closedposition.
 12. The apparatus of claim 1, further comprising an activationbutton configured to activate the first electrode surface and the secondelectrode surface to provide bipolar RF energy.
 13. The apparatus ofclaim 1, wherein the downwardly facing protrusion comprises an insertconfigured to be coupled with a remaining portion of the first jaw. 14.The apparatus of claim 1, wherein the upwardly facing protrusioncomprises an insert configured to be coupled with a remaining portion ofthe second jaw.
 15. The apparatus of claim 1, wherein the upwardlyfacing protrusion and the downwardly facing protrusion each compriseelectrically insulative material.
 16. An apparatus comprising: (a) abody; and (b) an end effector positioned distal to the body, wherein theend effector comprises: (i) a first jaw comprising a first electrodesurface configured to apply bipolar RF energy to tissue and a downwardlyfacing protrusion, wherein the downwardly facing protrusion comprises afirst PTC thermistor material, and (ii) a second jaw comprising a secondelectrode surface configured to apply bipolar RF energy to tissue and anupwardly facing protrusion comprising a second PTC thermistor material,wherein the upwardly facing protrusion is laterally offset from thedownwardly facing protrusion of the first jaw to define a lateral gap,wherein the first electrode surface and the second electrode surfacelaterally extend along the lateral gap, wherein the first and secondjaws are configured to transition between an open position, a firstclosed position, a second closed position, and third closed position,wherein the first jaw and the second jaw are operable to grasp tissue inthe first closed position, wherein the first electrode surface and thesecond electrode surface are operable to transmit bipolar RF energy totissue grasped between the first jaw and the second jaw in the secondclosed position, wherein the downwardly facing protrusion and theupwardly facing protrusion are configured to cooperatively sever tissuecaptured between the first jaw and the second jaw in the third closedposition, and wherein the first PTC thermistor material is configured tocontact a portion of the second electrode surface and the second PTCthermistor material is configured to contact a portion of the firstelectrode surface in the third closed position to define the lateralgap.
 17. The apparatus of claim 16, wherein the downwardly facingprotrusion is configured to abut against the second jaw in the thirdclosed position.
 18. The apparatus of claim 16, wherein the upwardlyfacing protrusion is configured to abut against the first jaw in thethird closed position.
 19. An apparatus comprising: (a) a body; and (b)an end effector positioned distal to the body, wherein the end effectorcomprises: (i) a first jaw comprising a first electrode surfaceconfigured to apply bipolar RF energy to tissue and a downwardly facingprotrusion, wherein the downwardly facing protrusion comprises a firstPTC thermistor material, and (ii) a second jaw comprising a secondelectrode surface configured to apply bipolar RF energy to tissue and anupwardly facing protrusion, wherein the upwardly facing protrusioncomprises a second PTC thermistor material, wherein the upwardly facingprotrusion is laterally offset from the downwardly facing protrusion ofthe first jaw, wherein the first and second jaws are configured totransition between an open position, a first closed position, a secondclosed position, and third closed position, wherein the first jaw andthe second jaw are operable to grasp tissue in the first closedposition, wherein the first electrode surface and the second electrodesurface are operable to transmit bipolar RF energy to tissue graspedbetween the first jaw and the second jaw in the second closed position,wherein the downwardly facing protrusion and the upwardly facingprotrusion are configured to cooperatively sever tissue captured betweenthe first jaw and the second jaw in the third closed position, whereinthe first PTC thermistor material of the downwardly facing protrusion isconfigured to contact a portion of the second electrode surface in thethird closed position, and wherein the second PTC thermistor material ofthe upwardly facing protrusion is configured to contact a portion of thefirst electrode surface in the third closed position, wherein the firstPTC thermistor material and the second PTC thermistor material define alateral gap in the third closed position, wherein the first electrodesurface and the second electrode surface extend along the lateral gap inthe third closed position.